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I. Purpose:

To establish a mechanism for the evaluation and treatment of the home health agency’s employees, contract staff, students, and visitors, after an accidental exposure to blood or other bloody fluids with potential for transmission of bloodborne pathogens.



II. Policy:

Florida Home Bound and its satellite agencies and contract facilities will provide timely evaluation to employees after accidental exposure to bloodborne pathogens, and will provide testing and prophylactic medication as indicated.

III. Definitions:

Bloodborne pathogens means pathogenic microorganisms that are present in human blood and can cause disease in humans.  These pathogens include, but are not limited to, hepatitis B virus (HBV), hepatitis C virus (HCV), and human immunodeficiency virus (HIV).

Exposure Incident means a specific eye, mouth, other mucous membrane, non-intact skin, on parenteral contact with blood or other potentially infectious materials that results from the performance of an employee’s duties.

Parenteral means piercing mucous membranes or the skin barrier through such events as needlesticks, human bites, cuts, or abrasions.

IV. Responsibility:

a. The CQI Department will be responsible for overall compliance with the present policy.

b. The Employee Health Office will be responsible for evaluation, counseling, and treatment of employees exposed during home health care interventions.  They will also keep a detailed log of each accidental exposure and report the consolidated data periodically.

c. The Infections Disease Section of the home health agency will be available for consultation and counseling of employees.  It will collaborate with the Employee Health Office on the production and periodic update of clinical protocols for the management of accidental exposures to bloodborne pathogens.

d. The employee will be responsible for reporting the exposure promptly, and for deciding whether to take prophylactic medication after being counseled.


V. Procedure:
  1. a. After a healthcare worker has an accidental exposure to blood or other potentially infectious material, he or she must wash the area immediately with soap and water, and report the incident to his or her supervisor.
  2. b. The employee will then go immediately to the Employee Health Office (9:00 a.m. – 5:30 p.m.) for evaluation and treatment
  3. c. If after hours or on weekends, the employee will go to the Emergency Room, who will provide first aid, counseling, and emergency post-exposure prophylactic medication.  (Attachment A)  The employee will then contact the Health Office on the next business day to complete evaluation and treatment.
  4. d. Consultation and follow-up with your doctor may be obtained to aid with the assessment of the exposure and counseling.
  5. e. The Employee Health practitioner will provide initial assessment of the exposure and the exposure source, as well as the susceptibility of the exposed person to bloodborne pathogens:


V. Procedure (.cont):
  1. 1. The source individual’s blood shall be tested as soon as feasible and only after informed consent is obtained to determine HBV, HCV and HIV infectivity, if not already known.  The results of these tests will be made available to the exposed employee.
    1. 2. The Employee Health Office will provide baseline and follow-up testing and referrals as needed for a minimum of six months after the exposure incident.  Testing will include serology against HIV, HbsAg and HCV, as well as ALT. Employee Health will also review the HBV vaccination status and anti-HbsAb, and use this data to determine the need for post-exposure management.  (Attachment D)
  2. f. Post-exposure testing and prophylactic medication will be provided to the employee in accordance with the latest standards of care (Attachments C, D and E).  If PEP for HIV is offered, healthcare worker signs the “Acceptance/Refusal of PEP” form (Attachment B).  If HCW accepts therapy, baseline CBC, CMP, and a pregnancy test, if indicated, will be obtained.
  3. g. Employees will receive initial evaluation (including baseline serologic studies), counseling, and a three-day supply of medication if indicated.
VI. Procedure:


VII. References:

    U.S. Department of Labor, Occupational Safety and Health Administration, Occupational Exposure to Bloodborne Pathogens; Final Rule. 29 CFR Part 1910.1030.1991.

    Centers for Disease Control and Prevention.  Updated U.S. Public Health Service Guidelines for the Management of Occupational Exposures to HBV, HCV and HIV, and Recommendations for Postexposure Prophylaxis.  Morbidity and Mortality Weekly Report 2001; 50 (RR-11)




To protect both client and caregivers, infection control procedures should be followed on home setting.

  1. 1.  Hand washing, is perhaps the easiest, as well as most important, and effective way to prevent transmitting infection from one person to another. Client/caregiver should wash their hands thoroughly before and after providing client care, as well as before and after contact with contaminated/potentially contaminate items. If in doubt as to what may or may not be contaminated, be safe. WASH YOUR HANDS!
  2. 2.  Use latex or other disposable gloves – Gloves should be worn when handling and/or disposing of any of the following:
    1. a.  Blood
    2. b.  Urine
    3. c.  Feces
    4. d.  Sputum
    5. e.  Any blood fluid or secretion
  3. 3.  Be sure to dispose of any contaminated/potentially contaminated item, e.g., Kleenex, by placing in a sealable plastic bag.
  4. 4.  Your clinician will construct you on appropriate infection control measures including the proper methods for disposal. If you have any questions/concerns throughout the time services are being provided to you, ask your nurse or therapist, or contact our offices.
  5. 5.  For any questions/concerns regarding Infectious Disease, contact your Physician.
  6. 6.  Have disposable tissues available for everyone to use. Sanitize surface areas that are frequently touched.



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Clinical Compliance

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