Practice recommendation
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Implementation checklist
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Establish a bloodborne pathogen policy. |
All institutions where health-care personnel (HCP) might experience exposures should have a written
policy for management of exposures. |
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The policy should be based on the U.S. Public
Health Service (PHS) guidelines. |
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The policy should be reviewed periodically
to ensure that it is consistent with PHS
recommendations. |
Implement management policies. |
Health-care facilities (HCF) should provide
appropriate training to all personnel on the
prevention of and response to occupational
exposures. |
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HCF should establish hepatitis B vaccination
programs. |
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HCF should establish exposure-reporting systems. |
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HCF should have personnel who can manage an
exposure readily available at all hours of the day. |
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HCF should have ready access to postexposure
prophylaxis (PEP) for use by exposed personnel as necessary. |
Establish laboratory capacity for bloodborne pathogen testing. |
HCF should provide prompt processing of
exposed person and source person specimens to guide management of occupational exposures. |
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Testing should be performed with appropriate
counseling and consent. |
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Practice recommendation
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Implementation checklist
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Select and use appropriate PEP regimens. |
HCF should develop a policy for the selection
and use of PEP antiretroviral regimens for HIV exposures
within their institution. |
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Hepatitis B vaccine and HBIG should be
available for timely administration. |
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HCF should have access to resources
with expertise in the selection and use of
PEP. |
Provide access to counseling for exposed HCP. |
HCF should provide counseling for HCP who
might need help dealing with the emotional effect of an
exposure. |
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HCF should provide medication adherence counsel ing to assist HCP in completing HIV PEP
as necessary. |
Monitor for adverse effects of PEP. |
HCP taking antiretroviral PEP should be monitored periodically for adverse effects of PEP through
baseline and testing (every 2 weeks) and
clinical evaluation. |
Monitor for seroconversion. |
HCF should develop a system to
encourage exposed HCP to return for follow-up testing. |
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Exposed HCP should be tested for HCV and HIV. |
Monitor exposure management programs. |
HCF should develop a system to monitor
reporting and management of occupational exposures to ensure timely and appropriate response. |
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Evaluate
- exposure reports for completeness
and accuracy,
- access to care (i.e., the time of exposure to the
time of evaluation), and
- laboratory result reporting time.
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Review
- exposures to ensure that HCP exposed to sources not infected with
bloodborne pathogens do not receive PEP or that PEP is stopped.
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Monitor
- completion rates of HBV vaccination and
HIV PEP and
- completion of exposure
follow-up.
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