AOHP: Needlesticks still top agenda for EHPs
AOHP: Needlesticks still top agenda for EHPs
Consent testing, safe lifting rank as concerns
Reducing bloodborne pathogen exposures remains a primary concern for employee health nurses, according to a survey of members by the Association of Occupational Health Professionals in Healthcare (AOHP).
"It's still a challenge. Even with safety devices, staff [members] are still having exposures," says MaryAnn Gruden, MSN, CRNP, NP-C, COHN-S/CM, employee health coordinator at Western Pennsylvania Hospital in Pittsburgh and AOHP community liaison.
The testing of source patients remains a particularly difficult area for employee health professionals. There are myriad state laws, some of them with strict consent requirements. In some circumstances, employees who suffer a needlestick must undergo prophylaxis as if the source patient is unknown because the patient can't or won't consent to testing, says Gruden.
In 2006, the Centers for Disease Control and Prevention recommended that HIV testing become a routine part of care, with patients given the opportunity to "opt out." With routine HIV testing, more patients would know their status when entering the hospital.
However, consent laws and concern about reimbursement for the tests has made it difficult to implement those recommendations in some locales.
At Aurora Medical Center Manitowoc County in Two Rivers, WI, the hospital wasn't able to incorporate consent for HIV testing into the general consent for treatment that patients sign upon admission. A recent scenario highlighted the possible dilemmas over testing, says Lynne Karnitz, RN, MS, COHN-S, employee health and wellness nurse, who also is executive vice president of AOHP.
An employee suffered an exposure during surgery on a patient with hepatitis B and C, who subsequently died. The patient's blood had been collected for a different reason, and the patient's family agreed to allow HIV testing. That averted the need to treat the case as an "unknown" source and to place the employee on HIV prophylaxis, she explains.
"[Consent laws create] issues that are really sensitive in nature and difficult for us to maneuver," Karnitz says.
Changing those consent laws would need to occur state by state. But AOHP is working with the U.S. Occupational Safety and Health Administration and others to improve education about post-exposure testing and prophylaxis and to create better benchmarking information.
A second area of concern for employee health nurses remains safe patient handling. AOHP is working with OSHA to produce updated guidance, which would reflect the newest technology, says Karnitz.
Her own facility reflects the potential benefits of safe patient handling. The hospital installed ceiling lifts in the emergency department and radiology rooms; for the first quarter of 2009, there were no patient handling injuries.
Reducing bloodborne pathogen exposures remains a primary concern for employee health nurses, according to a survey of members by the Association of Occupational Health Professionals in Healthcare (AOHP).Subscribe Now for Access
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