CLINICAL LAB SCIENEC

CHAPTER 6: INTRODUCTION TO INFECTION CONTROL 133
performed for any employee at any time. Remember, except in limited situations,
the patient has the right to refuse to have his or her blood tested, so it is important
that a person with a potential exposure make a rational decision. The potentially
exposed employee will be offered a confidential medical evaluation and follow-up,
which will include the information below.
Essential Steps for Documentation of an Exposure Incident
1. Documentation of the route(s) of exposure, previous HBV and HIV
antibody status of the source patient(s) (if known), and the circumstances
under which the exposure incident occurred.
2. If the source patient can be identified and it is feasible, with the patient’s
permission, collection and testing of the patient’s blood should be conducted
to determine the presence of HIV and/or HBV infections.
3. If the patient does not consent to furnishing a specimen, the employer shall
establish that legally required consent cannot be obtained. If the source individual’s
consent is not required by law, as is covered by applicable laws in
some states , his or her blood , if available, will be tested and the results documented.
If the source patient is already known to be HIV or HBV positive,
repeat testing is not required.
4. Results of the source individual’s testing should be made available to the
medical worker, faculty member, or student, and the affected persons should
be informed of the applicable laws and regulations concerning disclosure of
the identity and infectious status of the source individual.
5. The exposed health care employee or student’s blood should be collected as
soon as feasible and tested after consent is obtained from the person exposed
to HBV or HIV.
6. If the medical facility employee, instructor, or student consents to baseline
blood collections but does not give consent at that time for HIV serologic
testing, the sample is preserved for at least 90 days. If, within a 90-day period
of the exposure incident , the individual elects to have the baseline sample
tested, testing will be done as soon as feasible.
7. The educational facility and the medical facility shall ensure that the health
care professional responsible for the medical worker’s, instructor’s, or student’s
hepatitis B vaccination is provided a copy of the regulation for “Occupational
Exposure to Bloodborne Pathogens.”
8. The educational institution shall ensure that the health care professional
evaluating an employee after an exposure incident is provided with the
information in the “Infection Control Alert” box on the next page.
9. The facility shall obtain and provide the employee with a copy of the consulting
health care professional’s written opinion within 15 days of the completion
of the evaluation. The health care professional’s written opinion for
HBV vaccination shall be limited as to whether the vaccination is indicated
and if the medical worker, instructor, or student received such vaccination.
NOTE: An employee who declined HBV immunization and is subsequently
exposed may be immunized within a few days of the incident. This will usually
provide protection to the employee, as will administration of gammaglobulin–containing
antibodies against the virus.
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