APPENDIX G UW Oshkosh Post-Exposure Follow-Up Procedure

APPENDIX G – UW Oshkosh Post-Exposure Follow-up Procedure

University of Wisconsin Oshkosh

POST-EXPOSURE EVALUATION AND FOLLOW-UP PROCEDURE

Mercy Oakwood Medical Center, 2700 West 9th Avenue, Oshkosh, Wisconsin, will provide post- exposure evaluation and follow-up for at-risk University of Wisconsin Oshkosh employees. Referrals should be made to the Occupational Health Department on weekdays (8 a.m. to 5 p.m.) or to Immediate Care on weekends (9 a.m. to 3 p.m.). Holiday referrals should be made to Mercy Medical Center Emergency Room at 631 Hazel Street (920-236-2082).

I. Following a potential exposure incident, the employee should:

A. Cease work immediately and treat the exposed site as follows:

A.1. If there is a needle puncture, laceration or broken skin:

A.1.a. Squeeze the puncture or open area to include bleeding.

A.1.b. Cleanse the wound thoroughly with soap and water.

A.2. If there is an eye, mouth, or other mucous membrane exposure, rinse the affected area with copious amounts of water.

II. Report the incident to the department supervisor immediately after completion of fist aid. (If the incident takes place during the evening, weekends, or holidays when a supervisor is not present, contact the University Police for assistance.)

NOTE: If the incident takes place at a clinical site, follow the procedure established by the clinical site, also.

III. Following a potential exposure incident, the supervisor should:

A. Contact the Human Resources Department (or University Police during off- hours) for the necessary post-exposure follow-up forms and referral assistance.

B. Together with the employee, complete Sections I, II and III of the Determination of Exposure to Blood/Body Fluids, WKC-8165 (Form 1) and the supervisor and employee portions of the Occupational Accident and Illness Report, DOA 6058 (Form 2).

NOTE: Include a description of the employee’s job duties as they relate to the exposure incident when completing Section III of Form 1. C. Obtain the exposed Employee’s Consent/Refusal for Human Immunodeficiency Virus and/or Hepatitis B Virus Serological Testing (Form 3).

D. Obtain the Source Consent/Refusal for Human Immunodeficiency Virus and/or Hepatitis B Infectivity Status (Form 4). (If the source person consents to testing, but is unwilling or unable to go to Mercy Oakwood, instruct the source individual to have their test results sent to: Mercy Oakwood Medical Center, c/o Occupational Health, 2700 West 9th Avenue, Oshkosh, Wisconsin 54901

E. If the injury occurs between 7:45 a.m. and 4:30 p.m., Monday through Friday, send the exposed employee to the Human resources Department, Dempsey Hall, Room 328, with the completed forms in hand.

IV. If the injury occurs after hours or on a weekend:

A. Send the employee (and source individual, if agreed) to Mercy Oakwood Immediate Care, within 24 hours, with the Determination of Exposure to Blood/Body Fluids form (Form 1) in hand.

B. Contact Mercy Medical Center emergency Room (920) 236-2082 to inform them of the employee’s and sources pending arrival.

C. Notify the Human Resources Department of the incident on the next working day.

D. Send the following completed forms to the Human Resources Department: Occupational Accident and Illness Report (Form 2), Employee consent/Refusal for Human Immunodeficiency Virus and/or Hepatitis B Virus Serological Testing (Form 3) and Source Consent/Refusal for Human Immunodeficiency Virus and Hepatitis B Infectivity Status (Form 4).

NOTE: If the incident takes place on a holiday, send the employee to Mercy Medical Center Emergency Room.

V. Following a potential exposure incident, the Human Resources Department should:

A. Confirm the information recorded on all forms.

B. Send the employee (and source, if agreed) to Mercy Oakwood Occupational Health Department, within 24 hours, with the Determination of Exposure to Blood/Body Fluids (form 1) in hand.

C. Contact Mercy Oakwood Occupational Health Department (920-236-1815) to inform them of the employee’s and source’s pending arrival. D. Determine if the exposed individual wishes to seek legal counsel if the source individual refuses consent.

E. Process the Occupational Accident and Illness Report (Form 2) according to worker compensation procedure.

F. Complete the Checklist, Information to be provided to Healthcare Professional, (Form 5) and place in the employee’s medical file.

G. Provide the employee with a copy of Mercy Oakwood’s written opinion for hepatitis B vaccination and/or post-exposure follow-up evaluation within 15 days of the completion of the evaluation.

H. Record the exposure incident on the OSHA 200 Log if it meets recordable requirements (See OSHA Instruction CPL 2-2.44C).

The Risk Manager will review the circumstances surrounding the exposure incident as soon as possible. If warranted, revisions of the Exposure Control Plan, to reduce the likelihood of similar incidents in the future, will be recommended.