Infected HCWs should agree to IC training, twice-yearly tests
According to a new guideline from the Society for Healthcare Epidemiology of America, the following recommendations apply to health care workers infected with HIV or hepatitis B or C.
Responsibilities of the healthcare provider
1. Agrees to twice yearly follow-up by Occupational Medicine, including measurement of viral burden using tests specified by the panel.
2. Agrees to twice yearly evaluations by a private physician who has expertise in the provider's specific bloodborne pathogen infection and agrees to have this physician discuss the results of these evaluations with the provider's Expert Review Panel.
3. Agrees to formal training in infection control via a course identified by the infection control expert, or, alternatively agrees to counseling by the infection control professional concerning the use of appropriate infection control procedures, safety devices and work practice controls.
4. Agrees to follow the recommended procedures and practices identified in the previous item (responsibility 3).
5. Agrees to notify the occupational medicine or the public health authority participating in the panel regarding any change in provider status that may increase risk to the patient (eg, new neurological findings, development of another contagious disease [eg, tuberculosis]).
6. Acknowledges the ethical obligation to do so, and agrees to report instances immediately in which a patient exposure may have occurred to the hospital epidemiologist or to appropriate institutional/public health authorities identified in the contract, so that the potentially exposed patient may receive appropriate post-exposure management and counseling.
7. If receiving treatment, agrees to continue treatment as prescribed and agrees to notify occupational medicine if the treatment regimen is modified for any reason.
8. Agrees to re-evaluation by expert panel and revision of contract should clinical status or viral burden change.
Responsibilities of the institution and/or public health authorities
1. Agrees to convene Expert Review Panel at least twice annually (see text) to assess provider's clinical and virologic status as well as the provider's ongoing performance and her or his ability to continue to perform requested procedures.
2. Agrees to maintain provider's medical privacy and confidentiality.
3. Agrees to develop and follow institutional or provider-based follow-up procedure for potential patient exposure that makes every effort to ensure practitioner confidentiality.
4. Panel participants should have no liability.
5. Develops process for notifying hospital Risk Management.