Needlestick or Other Blood Exposure Procedures JITT – Phase 1A Vaccine Event

Needlestick Injury or Other Blood Exposure Procedure Purpose: Prevent transmission of bloodborne pathogens. Definition of substantial exposure to potentially infectious body fluids: Any percutaneous, mucosal, or non-intact skin contact with the blood or other potentially infectious bodily fluids of another person. In some instances, the Health Department may consider gross exposure of intact skin to these materials a substantial exposure at its discretion.

The following are not substantial exposures: • Contact with blood on intact skin away from areas of the mouth nose, or eyes. • Contact with urine or stool away from areas of the mouth nose or eyes. • Exposure to non-bloody saliva—even in the eye, nose or mouth. • Contact with dried blood away from the mouth, nose or eyes.

What to do if I get a needlestick Employee, contract employees or volunteers: • Step 1: Provide immediate care to the exposure site. Wash wound and skin with soap and water. • Step 2: Report exposure to your supervisor. *Contract employees follow the guidance below for your company. • Step 3: Within 24 hours, seek medical care for a needlestick. Go to MultiCare Occupational Health, Concentra, Community HealthCare, Urgent Care or a medical provider of your choice. They will test you for , and HIV. Make sure that you tell them that this is an on-the-job injury. See locations below. • Step 4: Complete an On-the-Job Injury Report.

Supervisor/Nurse: • Step 1: Obtain history from source. Assess risk for HIV, hepatitis B, and hepatitis C. • Step 2: Obtain written consent from source. • Step 3: Test source patient or send to one of the clinics listed below. The Department pays the bill for this service. • Step 4: Determine exposure risk, i.e. type of fluid, gauge of needle. • Step 5: Complete incident report.

*Staff assigned through Temporary Agencies (Contract employees):

Express HealthCare: Contact your agency immediately. The Clinical Director will advise next steps i.e. Blood draw, infection control, workers compensation.

Staff Today: Contact Med-Call Advisors at (855) 963-3225 for treatment directions. Then, call Staff Today and inform them of the incident.

BizTek People: Follow Health Department process. List BizTek People, Inc. as your employer for L&I.

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Needlestick Injury or Other Blood Exposure Procedures JITT – Phase 1A Vaccine Event

Clinic hours and locations: MultiCare Occupational Medicine - Tacoma Community HealthCare Hilltop Clinic Monday – Friday 8 a.m. to 4:30 p.m. Monday – Friday 8 a.m. to 5 p.m. 3124 S. 19th St. Bldg. C, Suite 110 1202 Martin Luther King Jr. Way, 3rd floor Tacoma, WA 98405 Tacoma, WA 98405

MultiCare Occupational Medicine - Puyallup Concentra – Tacoma- Bring completed authorization Monday – Friday 8 a.m. to 4:30 p.m. Monday – Friday 8 a.m. to 5 p.m. 1450 5th St. SE, Suite 1500 Saturday 9 a.m. to 5 p.m. Puyallup, WA 98372 2602 S. 38th St. C Tacoma, WA 98405

Concentra – Puyallup – Bring completed authorization Monday – Friday 8 a.m. to 5 p.m. Saturday 9 a.m. to 5 p.m. 3850 S Meridian Suite 10 Puyallup, WA 98373

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Needlestick Injury or Other Blood Exposure Procedures JITT – Phase 1A Vaccine Event

What to do if I have a bloodborne pathogen exposure *Contract employees and volunteers follow the guidance below for your organization.

Step 1: Immediate Actions • Wash wound and skin with soap and water. Who: Employee • Flush mucous membranes with water. • Report to your supervisor. Step 2: Assess situation Assess for substantial exposure. Who: Employee and • Any percutaneous, mucosal, or non-intact skin contact with the Supervisor blood or other bodily fluids contaminated with blood. In some instances, the Health Department may consider gross exposure of intact skin to these materials a substantial exposure at its discretion. The following are not substantial exposures: • Contact with blood on intact skin away from areas of the mouth, nose or eyes. • Contact with urine or stool away from areas of the mouth, nose or eyes. • Exposure to non-bloody saliva—even in the eye, nose or mouth. • Contact with dried blood away from the mouth, nose or eyes. Assess risk of source being infected. Is the source in a higher risk group? • Current HIV infection • Males who have sex with males • Current or past IV drug use

This information will assist healthcare provider and employee decide need for post-exposure prophylaxis for HIV. Step 3: Assess hepatitis B • If documented serologic conversion on file, hepatitis B testing not immune status of needed for employee or source. employee. • If not documented or employee is not immune, source and Who: Employee and employee will need hepatitis B testing. Supervisor—To verify, call Dawn Avcular, ext. 4406 or Carol Korst, ext. 3783. Step 4: Communicate with • Ask source to stay until the necessary post exposure activities are Source Person complete. Who: Supervisor and/or o If source cannot stay, make sure you have enough information to Employee contact and locate later. • Ask source to consent to HIV and HCV testing. Hepatitis B testing if needed. • If source refuses testing, contact CD/EPI program for assistance (253- 798-6410).

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Needlestick Injury or Other Blood Exposure Procedures JITT – Phase 1A Vaccine Event

Step 5: Perform or coordinate • Rapid HIV. source person testing. o If positive, draw blood for confirmatory test. Who: Supervisor; STD Team • Rapid HCV. o If positive, draw blood for hepatitis C RNA. • If employee hepatitis B surface antibody negative or unknown, draw blood for HBsAg (hepatitis B surface antigen). • Document results of rapid testing and give results to source person. • Document results on exposure form. Step 6: Refer employee for • Give employee instructions to seek post-exposure evaluation. They evaluation and can go to MultiCare Occupational Health, Concentra, Community baseline testing. HealthCare, Urgent Care, or a medical provider of their choice. Who: Supervisor/Nurse Locations listed below. • Give employee exposure form in a sealed envelope. Employee will give to health care provider. • Inform employee they get the source person’s test results to help them coordinate their own care. They must keep the results confidential. Step 7: Follow up and closure. • Follow up on any source person testing that is pending. Who: Supervisor • Follow through with employee with results as needed.

Clinic hours and locations: MultiCare Occupational Medicine—Tacoma Community HealthCare Hilltop Clinic Monday – Friday 8 a.m. to 4:30 p.m. Monday – Friday 8 a.m. to 5 p.m. 3124 S. 19th St. Bldg. C, Suite 110 1202 Martin Luther King Jr. Way, 3rd floor Tacoma, WA 98405 Tacoma, WA 98405

MultiCare Occupational Medicine—Puyallup Concentra—Tacoma Monday – Friday 8 a.m. to 4:30 p.m. Monday – Friday 8 a.m. to 5 p.m. 1450 5th St. SE, Suite 1500 Saturday 9 a.m. to 5 p.m. Puyallup, WA 98372 2602 S. 38th St. C Tacoma, WA 98405 Concentra—Puyallup Monday – Friday 8 a.m. to 5 p.m. Saturday 9 a.m. to 5 p.m. 3850 S Meridian Suite 10 Puyallup, WA 98373

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Needlestick Injury or Other Blood Exposure Procedures JITT – Phase 1A Vaccine Event

Consent for Source Testing

A healthcare worker has accidentally sustained an exposure to your blood. To follow current regulations, we request you give blood to test for HIV, hepatitis B and hepatitis C.

There will be no charge to you. The results of the tests are confidential. Only the healthcare provider of the healthcare worker will see them, to help the healthcare worker get necessary testing and treatment. You can get your HIV test results today and get a phone number to call for the results of the hepatitis testing.

I agree to the testing for HIV, hepatitis B and hepatitis C.

______

Print name

______Date ______

Signature

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