Preparing for the CBIC Test

APIC DFW Professional Advancement

•Review and/or develop screening and immunization programs

•Provide counseling, follow-up, and work restriction recommendations related to communicable diseases or following exposures

•Assist with analysis and trending of occupational exposure incidents and information exchange between Occupational Health and Infection Prevention and Control departments

•Assess risk of occupational exposure to infectious diseases (e.g., tuberculosis, bloodborne pathogens)

OBJECTIVES

Primary References:1. Grota P, ed. APIC Text of Infection Control and Epidemiology, 4th edition. Washington, DC: Association for Professionals in Infection Control and Epidemiology, 2014. Also available online at http://text.apic.org [subscription required]

RESOURCES FOR STUDY

Primary References (cont’d):Notable Chapters71Bordatella pertussis80Herpes Virus81HIV/AIDS82Influenza86Measles, Mumps, Rubella87Neisseria meningitidis95Tuberculosis and Other Mycobacteria97Viral Hepatitis100Occupational Health101Occupational Exposure to Bloodborne Pathogens102Volunteers, Contract Workers, and Other Nonemployees Who Interact with Patients103Immunization of Healthcare Personnel104Pregnant Healthcare Personnel105Minimizing Exposure to Blood and Body Fluids

RESOURCES FOR STUDY

Primary References (cont’d):2. Brooks K. Ready Reference for Microbes, 3rd edition. Washington, DC: Association for Professionals in Infection Control and Epidemiology, 2012.3. Heymann D, ed. Control of Communicable Diseases Manual, 19th edition. Washington, DC: American Public Health Association, 2008

RESOURCES FOR STUDY

Primary References (cont’d):4. Kulich P, Taylor D, eds. The Infection Preventionist’s Guide to the Lab. Washington, DC: Association for Professionals in Infection Control and Epidemiology, 2012.

RESOURCES FOR STUDY

Secondary References:1.ACIP. Vaccine Recommendations of the ACIP. Available at: http://www.cdc.gov/vaccines/acip/.2.Current guidelines, standards, and recommendations from CDC, APIC, SHEA, and Public Health Agency of Canada3.Pickering LK, ed. Red Book: Report of the Committee on Infectious Diseases, 29th edition. Elk Grove Village, IL: American Academy of Pediatrics, 2012.

RESOURCES FOR STUDY

a. Educate personnel about the principles of infection prevention and their individual responsibility for infection prevention

b. Collaborate with the infection prevention department in monitoring and investigating potentially harmful infectious exposures and outbreaks.

c. Provide care to personnel for work-related illnesses or exposures.

d. Identify work-related infection risks and institute appropriate preventive measure.

e. Contain costs by preventing infectious diseases that result in absenteeism and disability

IP OBJECTIVES OF AN EMPLOYEE HEALTH

PROGRAM

A. Administration1. Organizational issues

2. Policies, procedures and protocols

MAJOR COMPONENTS OF AN OCCUPATIONAL HEALTH

PROGRAM (OHP)

B. Operational Issues1. Screening

2. Education and counseling

3. Occupational illness and injury treatment

4. Nonoccupational illness treatment

5. Preventive health services

6. Environmental assessment and control

7. Record keeping. The maintenance of OHP records, data management and confidentiality are required by federal, state and local standards; copies of individual records are to be made available to the worker upon request.

MAJOR COMPONENTS OF AN OCCUPATIONAL HEALTH

PROGRAM (OHP)

C. Communication Between the IP and Personnel in the OHP

1. Share information related to:

a. Healthcare worker exposure to communicable diseases

b. Healthcare worker infections

c. Community and personnel outbreaks

d. Development of policies and procedure for occupational health

e. Educational programs for healthcare workers.

MAJOR COMPONENTS OF AN OCCUPATIONAL HEALTH

PROGRAM (OHP)

D. Occupational Health Professional1. Coordinates and performs the activities of the OHP

E. Medical Advisor or Consultant1. Collaborates in the development of protocols2. Serves as a resource to the occupational health professional when needed in assessing, screening or

treating healthcare workers.F. Healthcare Personnel

CDC defines the term healthcare personnel as all paid and unpaid persons working in healthcare settings who have the potential for exposure to infectious materials, including body substances, contaminated medical supplies and equipment, contaminated environmental surfaces or contained air.

MAJOR COMPONENTS OF AN OCCUPATIONAL HEALTH

PROGRAM (OHP)

G. Policies and Procedures Needed to Implement an Effective OHP1. Work restrictions2. Criteria for disease exposure and prophylaxis3. Screening procedures4. Illness reporting system5. Methods of detecting, preventing and controlling disease6. Protocols for treatment of occupational injuries and illnesses7. Protocols for treatment of non-occupational illness

MAJOR COMPONENTS OF AN OCCUPATIONAL HEALTH

PROGRAM (OHP)

H. Screening for Disease Detection, Prevention and Control1. Determined by

a. Incidence of disease in local populationb. Risk of significant exposure in healthcare

workers’ work- related activitiesc. Cost of screeningd. Implications of the results of screening

2. Purposes of screening3. Components of OHP screening4. Communicable Disease screening by OHP5. Employee illness/injury treatment6. Preventive health services7. Environmental assessment and intervention8. Occupational health records– confidential unless release form is signed

MAJOR COMPONENTS OF AN OCCUPATIONAL HEALTH

PROGRAM (OHP)

I. Transmission of Infection to and from the Healthcare Worker1. Vaccine preventable diseases2. Diseases with post-exposure intervention3. Diseases with no post-exposure intervention4. Work restrictions related to communicable disease

MAJOR COMPONENTS OF AN OCCUPATIONAL HEALTH

PROGRAM (OHP)

J. Education1. New healthcare worker employee orientation2. Annual healthcare worker updates3. Post-exposure counseling4. HIV/AIDS, hepatitis B or C exposure counseling5. TB exposure testing recommendations and positive skin test conversions6. Workers’ compensation issues7. Pregnant worker concerns8. Community-acquired infections– non-work-related9. Influenza prevention10. Measles, mumps, rubella and chickenpox protection and prevention11. Laboratory, radiology and cardiology results and analysis of testing done by OHP12. Employee illness guidelines related to fever, respiratory illness, draining lesions, diarrhea, etc.

MAJOR COMPONENTS OF AN OCCUPATIONAL HEALTH

PROGRAM (OHP)

K. Plan of Action for Detection, Prevention and Control of Diseases That Are a Threat to Healthcare Workers1. Detection

a. History of diseaseb. Symptomsc. Laboratory studiesd. Reporting of cases to health department

2. Prevention and controla. Isolation precautions for patientsb. Work restrictions for employeesc. Appropriate barrier treatmentd. Prophylaxis of patient and healthcare workerse. Education for healthcare worker and patientf. Screening tests post-exposureg. Follow-up to determine secondary cases or delayed

outbreak

MAJOR COMPONENTS OF AN OCCUPATIONAL HEALTH

PROGRAM (OHP)

L. Occupational Blood or Body Fluid Exposure Management (pg 250)

M. Respiratory Protection Program

N. Occupational Health Hazards: Post-exposure Interventions

O. Guidelines for Work Restrictions for Employees with Infectious Diseases

P. Immunizations Recommended for Healthcare Workers (pg 258-264)

Q. Performance Improvement in Preventing Occupational Exposure

MAJOR COMPONENTS OF AN OCCUPATIONAL HEALTH

PROGRAM (OHP)

Cheryl Sharp817-965-1561 (Cell)

817-848-4068 (Work)Cheryl.Sharp@TexasHealth.org

QUESTIONS???

Jerry Kelley817-705-7822 (Cell)

817-255-1899 (Work)Gerard.Kelley@hcahealthcare.com

Infection Prevention Competency Review Guide- 4th & 5th Editions, Carol McLay, DrPH, MPH, RN, CIC