Employee/ Occupational Health

Question 1

CDC defines health care personal as:

Answer 1

All paid and unpaid persons working in a healthcare setting who have the potential for exposure to infectious material

Question 2

Employee health vaccine preventable diseases

Answer 2

Hep a and b
Influenza 
Measles mumps rubella
Pertussis
Polio
Varicella/zoster
Tetanus and diphtheria

Question 3

What diseases require ohs Post exposure intervention

Answer 3

Tb
Measles/rubeola
neisseria meningitis
Yep a and b
Varicella/zoster
Scabies
Pertussis
HIV

Question 4

What disease do NOT require ohs post exposure intervention

Answer 4

Herpes
Cytomegalovirus 
Meningitis not caused by n. Meningitis
Rsv
Rotovirus
Hep c

Question 5

Steps following blood or body fluid exposure:

Answer 5

First aid using soap and water/oh,ER if needed
Notify immediate supervisor
Obtain baseline lab work for hiv, heps
Obtain lab for hiv heps for source patient- with consent
Fill out paperwork
Follow up for post exposure testing
High risk counseling if needed

Question 6

Post exposure interventions for TB

Answer 6

PPD skin testing at time of exposure and 12 weeks
Chest X-ray for symptomatic and prior positive skin test.
Immunocompromised staff retested every 6 months due to anergy

Question 7

Measles post exposure prophylaxis and immunity:

Answer 7

Measles vaccine given to susceptible workers within 72 hours of exposure.
Excluded from work from day 5 to day 21 after exposure.

Immunity by 2 dose vaccination record, physician diagnosis, or serological evidence of immunity. Pre 1957 same except only need 1 dose.

Question 8

Mumps immunity

Answer 8

Physician diagnosed mumps
2 doses vaccine
Serological evidence of immunity
Birth before 1957

Question 9

Meningococcal meningitis post exposure

Answer 9

Advised for anyone with intense (mouth to mouth, intubation, op exam) unprotected(no mask) contact with infectious patient

Therapy should be started immediately

Cipro oral for adults and non preggers
Ceftriaxime for kids and pregnant
Rigampin oral for kids or adults

Question 10

Hep B post exposure prophylaxis

Answer 10

If source is HBsAg positive or unknown
For vaccinated- check for immunity
For unvaccinated- start vaccine series and hbig within 24 hours of exposure

Question 11

Hep c post exposure prophylaxis

Answer 11

Baseline anti-hcv testing and alt activity at baseline and follow up testing 4 to 6 months later.

If positive refer to specialist for new treatment options

Question 12

HIV post exposure follow up

Answer 12

Worker and source tested for hiv antibody
Follow up testing 6 weeks, 3 months, 6 months
Post exposure prophylaxis should start as soon as possible
If source is HIV negative then stop pep
If pregnant consult ob for best pep
Monitor pep toxicity

Question 13

Varicella immunity and post exposure follow up

Answer 13

Immunity: varicella history, vaccination.

Follow up:
Serotest for immunity
If no immunity exclude from day 10-21 post exposure (28 if vzig given) or until all lesions are dry and crusted
Vzig may be given to people under 15 or over 15 immunocompromised

Question 14

Scabies follow up

Answer 14

Spread by prolonged skin to skin contact with infested person.
Contact precaution reduces spread
Employees screened for signs and symptoms and treated for confirmed or suspect scabies

Question 15

Pertussis follow up

Answer 15

Workers should have dose of tdap
Prophylaxis treatment erythromycin 500 four times a day or 1 tab Bactrim (trimethoprim-sulfamethoxazole)
Exposed no symptoms can work, symptoms exclude for 5 days of abx

Question 16

PPD result positive for immunocompetent health care worker with no known exposure

Answer 16

Greater than or equal to 10 mm

15 mm for no known risks.
5 for hiv, recent contact, etc

Question 17

There is a potential increase in needle sticks due to a new collection device- what is a useful denominator

Answer 17

Number of collection devices used/purchased

Question 18

How long is a non-immune HCW excluded from work after a varicella exposure? What about if VZIG given?

Answer 18

From day 10-21 after exposure. 28 days if given VZIG

Question 19

Under what circumstances should an HIV infected healthcare worker be placed under work restriction?

Answer 19

When required by state or regional regulations.

After council from an expert review panel is sought

Question 20

A unit in a long-term acute care facility is experiencing a break of crusted scabies. When is prophylaxis indicated for healthcare workers?

Answer 20

 Any staff volunteer visitors who may have been exposed to a patient with crusted scabies. Those with evidence of infestation such as itchy cutaneous rash.

Question 21

What’s the first thing you should do if you have a partial or total breach in PPE when dealing with ebola patient

Answer 21

Immediately moved to the doffing area to assess the exposure. Then implement exposure plan if indicated by assessment

Question 22

Activities to prevent hep c include

Answer 22

Screening of blood donors
Viral inactivation of plasma derived products
Risk reduction counseling and screenings of people at risk
Adherence to standard precautions

Question 23

What is the ips role in workers comp?

Answer 23

Their expertise may be needed to assess situations so they should be familiar with the worker’s compensation system in place

Question 24

What are potential sources for mycobacterium chelonae?

Answer 24

Bronchoscopes

Hydrotherapy pools

Question 25

Who should get the influenza vaccine

Answer 25

Anyone who works with high risk patients. If you work with lung transplant patients you really really should