Occupational Health Services - University of Miamigme.med.miami.edu › documents › Occupational_Health_Services.pdfOCCUPATIONAL HEALTH SERVICES Work- related injuries, exposures
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Occupational Health Services (OHS) Jackson Health System Appointments : (786) 466- 8381 [email protected]
OBJECTIVES: At the end of the presentation, attendees will be
able to :
Identify how to access Occupational Health Services (OHS) for routine services and for emergency evaluation and treatment for blood and body fluid exposures.
Outline the process of reporting work- related injuries, exposures or illnesses.
Access OHS- related information on the JHS Netportal.
Clinic Jackson Memorial Hospital Clinic
Medical Towers 1500 NW 12th Ave, Suite 1103, Miami, FL Phone: (305) 585- 6903 Hours of Operation: 7:30 AM to 4 PM Monday – Jackson Friday ( Closed Holidays)
Employee Health Records / Call Center Highland Professional Building 1801 NW 9th Ave. Suite 150 A Miami, FL Phone: (786) 466- 8381
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Presentation Notes
Call Center 786-466-8381 for Appointments / questions/ records requests
OCCUPATIONAL HEALTH SERVICES
Work- related injuries, exposures and illnesses
Needlesticks Infectious disease
exposures Immunizations TB Screening
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We are responsible for report-taking, evaluation, treatment, follow-up and referral for work-related injuries and illnesses. This includes blood and body fluid exposures, infectious disease exposures as well as exposures to hazardous substances. REPORT ALL INJURIES, EXPOSURES TO YOUR SUPERVISOR AND OCCUPATIONAL HEALTH AS SOON AS POSSIBLE AFTER THEY OCCUR Minor incidents such as… are evaluated and treated in the clinic. Serious injuries requiring consultation and treatment by specialists are referred to providers approved by Workers’ Compensation OHS also makes sure all injuries are recorded for OSHA and maintains records for the future complications. Report communicable disease exposure from home as well as work to allow time to prevent infection during the incubation period.
IMMUNIZATIONS IMMUNITY SCREENING
Hepatitis B (3) Varivax (2) Measles, Mumps
and Rubella ( MMR X 2)
Tetanus diphtheria (Td) booster
Annual Influenza TST (Annual or Q
6 Months ) Chest Xray
(Prehire) Titers
MMR HBsAb
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Vaccine preventable illnesses are on the rise because of waning immunity in an aging population and parents who failed to complete immunizations because of vaccine scares in the past and travel from unvaccinated countries . MMR is mandatory – Goal is to wipe the disease out. Chickenpox vaccine is highly recommended for those working with children or immunocompromised adults (Most are not immune) Flu.. Free and encouraged. Not only prevents flu but will help with diagnosis in case of a pandemic outbreak… Hep B.. Don’t be silly. Take it all the way…. ANNUAL TB TESTING (TST- Tuberculin Skin Test) : TB testing annually and more often if working in areas where there is according to CDC, the “potential for ongoing TB transmission,” such as the E.R. Also per CDC: persons at highest risk for exposure to and infection with M. tuberculosis include: “HCWs with unprotected exposure to a patient with TB disease before the identification and correct airborne precautions of the patient.” Optional but encouraged Screening Surgeons: Should know HIV and Hbsag and Hep C immunity…
DRUG TESTING
New Hire (30 days) For Cause Disruptive
Behavior Board Physicals Self Help
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Rules are set by Dade county ordinance..and DRUG FREE WORKPLACE New hires must complete testing prior to hire and no more than 30 days before start date. Involuntary testing: Mandatory.. By work rule and all union contracts can be ordered for cause which may include disruptive behavior, failure to perform, sleeping, etc. Voluntary testing as a service I want help!!!! Return to work after rehab Board physicals Risk management (Recovering persons for incidents where drug use may be used as a factor)
Occupational Health Records
Authorization Required for Release of Information
NEW HIRE PHYSICALS 30 DAYS!!! OR ELSE
DRUG TEST TST OR CHEST X-RAY MMR VARICELLA TITER HEP B VACCINE ?? RESPIRATOR FIT TEST
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HBV must be offered during prehire exam.
WORK- RELATED INJURIES, EXPOSURES AND ILLNESSES
Trips and falls Needlesticks Minor Strains and
sprains/ injuries Referrals to
Workers’ Compensation
EMERGENCY CARE @ JMH E.R. OR CLOSEST E.R.
Notify OHS next day or PAY!!
For serious events Notify your supervisor and
ON-CALL NURSE If no supervisor notify
Administrator in Charge (AIC)
OHS clinic F/U ASAP Bring Supervisor’s Referral
Form to document incident OHS clinic will file WC claim
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With the exception of needlesticks and other blood and body fluid exposures, you can be evaluated and treated at the JMH ER or the closest ER if working off-campus. In order to have the incident documented on your employee file and for any follow-up, please report the incident to OHS the next working day. A Supervisor’s Referral Form is needed in order to docement in your employee file and start a WC claim.
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Upper portion of Supervisor’s Referral Form. This is available in the units/ patient care areas. Will be available in the Netportal in the future.
NEEDLESTICKS/ BBF TREATMENT & COUNSELING
786-371-5038 needlestick@ jhsmiami.org (Use email for questions and non-urgent issues)
24/7
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Never guess.. For needlesticks, drug tests, exposure and any other occupational emergency. Feel free to call the 24/7 pager Nurse on call will provide counseling, call in a prescription or tell you where to go for treatment, assist with investigating the source patient for blood and body fluid exposures.
REPORTING & MEDICAL TREATMENT
NOTIFY CHARGE PERSON/ AIC
INCIDENT / IOD REPORT/ SOURCE MRN and NAME
CALL OHS : (786) 466- 8381 (786) 371-5038
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REPORT THE INJURY TO SUPERVISOR AND FILL OUT AN INJURY REPORT. EMPLOYEE CAN CALL THE OHS ON CALL NURSE FOR COUNSELING WITHOUT FILLING OUT AN INJURY REPORT EMERGENCIES REQUIRING SUTURES, ETC. SHOULD GO TO ER. THE ER WILL TREAT THE INJURY AND HAVE THE EMPLOYEE CALL EHS TO DETERMINE IF TREATMENT FOR THE EXPOSURE IS NECESSARY. OFF SHIFT PROBLEMS GETTING EHS CAN CALL AIC. THEY HAVE EVERYONES HOME NUMBER.
SOURCE TESTING FOR HIV, HEP B AND HEP C
CHARGE NURSE IS RESPONSIBLE DON’T DO IT YOURSELF QUESTIONS?
CALL OHS (786) 371-5038
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CHARGE NURSE CAN DELEGATE SOURCE INVESTIGATION PROCEDURE BUT MUST ALWAYS BE CONSULTED BEFORE SEEING A PATIENT. REQUESTS FOR SOURCE TESTING WILL EITHER COME DIRECTLY FROM THE UNIT OR FROM EHS ON BEHALF OF SOMEONE WHO WAS STUCK BY THE PATIENT THAT IS NOW RESIDING ON THE CHARGE NURSE’S FLOOR. THE COUNSELING REQUIRED FOR OCCUPATIONAL EXPOSURE IS DIFFERENT FROM ROUTINE PATIENT CARE COUNSELING. SOURCE INVESTIGATION PACKET AT BACK OF BBPECP (PLAN) INSTRUCTIONS FOR TESTING AND COUNSELING FOR COMMUNICATING AS WELL AS NON-COMMUNICATING PATIENTS, WHAT TO DO IF THE SOURCE REFUSES OCCUPATIONAL SOURCE CONSENT IN ENGLISH, SPANISH AND CREOLE GUIDE FOR REVIEWING THE RECORD FOR RISK FACTORS.
SOURCE INVESTIGATION: COMMUNICATING PATIENT
• SIGNIFICANT EXPOSURE • TEST INJURED PERSON FOR HIV • OBTAIN WRITTEN CONSENT • OCCUPATIONAL EXPOSURE CONSENT FORM
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FOR AN EMPLOYEE TO OBTAIN AN HIV TEST ON A SOURCE THERE MUST BE A SIGNIFICANT EXPOSURE AS DEFINED BY FLORIDA LAW AND THE EMPLOYEE MUST CONSENT TO HIV TESTING AND HAVE SPECIMEN DRAWN. THERE MUST BE A WRITTEN CONSENT OR PROOF THAT THE PERSON IS NON-COMMUNICATING OR REFUSED THE TEST. FOLLOW THE SCRIPT IN THE GUIDE AND USE THE OCCUPATIONAL EXPOSURE FORM. IT HAS ALL THE LEGAL INFORMATION YOU MUST GIVE A SOURCE. THE INFORMATION IN THE REGULAR HIV CONSENT DOES NOT
SOURCE COUNSELING
• HEALTH CARE WORKER WAS EXPOSED TO YOUR BLOOD
• OSHA LAW REQUIRES TESTING • RESULTS ARE CONFIDENTIAL ;
NO COST. NOT ON RECORD..NOT REPORTED
• CAN TEST BLOOD IN LAB • DO YOU WANT THE RESULTS?
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SOURCE COUNSELING NOT TO BE DONE BY INJURED HCW. THE UNIT’S CHARGE PERSON OR DESIGNEE IS REPONSIBLE FOR THIS
NON-COMMUNICATING PATIENT
• MUST BE GIVEN OPPORTUNITY TO CONSENT
• CONSENT: HAVE MD WRITE REASON AND DURATION
• BLOOD IN LAB DRAWN PRIOR TO OR AT TIME OF INJURY
• ILLEGAL TO DRAW NEW BLOOD
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OHS HANDLES OUTSIDE SOURCE INVESTIGATIONS. OHS ALSO HANDLES ALL REQUESTS FOR SOURCE TESTING FROM NON-PHT EMPLOYEES MUST MAKE AT LEAST 3 ATTEMPT IF OUT OF HOSPITAL (PHONE, LETTER, SOMETIMES POLICE) COURT ORDER IF SIGNIFICANT MOTHER CAN GIVE CONSENT FOR CHILD. DOCUMENTED SURROGATE CAN GIVE CONSENT EHS WILL MAKE SURE THE LAWS HAVE BEEN FOLLOWED AND TEST THE INJURED EMPLOYEE. IF THE INJURED EMPLOYEE IS NOT EVALUATED AND TESTED BY EHS, THE SOURCE RESULTS WILL NOT BE GIVEN TO THEM ILLEGAL TO CHARGE PATIENT FOR TESTING UNLESS THE TEST IS NEEDED FOR THE PURPOSES OF DIAGNOSING A PATIENT’S CONDITION FOR THE PURPOSE OF TREATING THE PATIENT. EHS IS ABLE TO GET BLOOD AND TEST 98% OF ALL INJURIES
PATIENT REFUSES TESTING • INFORM SOURCE THAT BLOOD
DRAWN PRIOR TO THE INCIDENT WILL BE TESTED
• DOCUMENT REFUSAL ON CONSENT FORM. GET A WITNESS
• TAKE FORM TO OHS • OHS WILL ARRANGE TESTING
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EHS WILL MAKE SURE THE LAW WAS FOLLOWED AND ARRANGE TESTING AFTER THE EMPLOYEE HAS BEEN TESTED BY EHS. ALL SOURCE BLOOD IS TESTED FOR HIV, HEPATITIS B AND HEPATITIS C. CONFIRMATORY TESTING DONE FOR POSITIVE TEST RESULTS
