1 NEEDLESTICKS, EXPOSURES AND WORKER S COMPENSATION Program Coordinator Quarterly Meeting - May 16, 2013 Erin Andersen, NP, Administrative Director, OHS Health Judy Rosen, Manager Disability and Leave Administration,
2 Needlestick & Exposure Hotline
3 BBP Exposure - Risks WHAT IS THE RISK OF TRANSMISSION? Route of exposure Risk of exposure when source person is HIV positive Factors increasing risk Needlestick ~0.3% Hollow bore needles, visibly bloody devices, deep injuries, devices used in an artery/vein Splash to mucous membrane ~0.09% Large amount > small volume Cutaneous <0.09% Must involve non-intact skin integrity Route of exposure Risk of exposure when source person is Hepatitis C positive Factors increasing risk Needlestick ~1.8% Hollow bore needles, visibly bloody devices, deep injuries, devices used in an artery/vein Splash to mucous membrane Unknown very low Large volume> small volume Route of exposure Risk of exposure when source person is Hepatitis B positive Factors increasing risk Needlestick ~6-30% Unvaccinated worker Needlestick Virtually no risk Vaccinated worker
4 BBP Exposures Process Step One Deglove and wash area with soap and water (rinse eyes with plain water or use eye wash station) Step Two Call 353-STIC (7842) Step Three Follow hotline clinician instructions
5 BP Exposures - Process Operator Services Initial answer to a real person Connects responder to caller Escalation process Ensures no unanswered calls or dropped pages.
6 BBP Exposures - Process Occupational Health Services Initial Responder Responds to page from Operator Services Triages call Decides if PEP is necessary Arranges PEP if needed Gives follow-up instructions
7 BBP Exposures - Process Occupational Health Services - RNs & NPs Initial visit with exposed employees Draws labs Determines follow-up schedule for employee Coordinates source patient testing Communicates all test results to employee
8 BBP Exposures Visits First visit Baseline labs: HIV, HCV, Hep B Surface Ab (for PEP/high risk) CBC, LFT, BUN, Creatinine, pregnancy Counseling 2 weeks (PEP/high risk only) Monitor symptoms & side effects from PEP Repeat labs 4 weeks (PEP/high risk only) Monitor symptoms & side effects from PEP Repeat labs 6 weeks Repeat HIV, HCV Hep C viral load (high risk) 3 months HIV, HCV 6 months Last HIV test 1 year Last HCV test
9 Needlestick & Exposure Worker s Compensation Claims
10 Worker s Compensation Overview California employers are required by law to have workers' compensation insurance, even if they have only one employee. Workers compensation laws are based on state (CA Labor Code), not federal regulations. UC is self-insured for worker s compensation through a Third Party Administrator (TPA) - Sedgwick CMS.
11 Worker s Compensation Overview Workers' comp insurance provides the following basic benefits: Medical care: Paid for by Sedgwick to help the EE recover from an injury or illness caused by work. Temporary disability benefits: Payments if EE loses wages because the injury prevents him/her from working during recovery. Permanent disability benefits: Payments for any lasting disability that results in a reduced earning capacity after maximum medical improvement is reached. Supplemental job displacement benefits (if the date of injury is 2004 or later): Vouchers help pay for retraining or skill enhancement if the employee doesn't return to work for the employer. Death benefits: Payments to the spouse or children.
12 Resident Worker s Comp. Statistics Fiscal Year claims 62% Sharps(medical and needle) 17% Body fluids Fiscal Year 2010/ claims 65% Sharps(medical and needle) 15% Body fluids Fiscal Year 2011/ claims 70% Sharps(medical and needle) 15% Body fluids Fiscal Year 2012/2013 (to 5/1/13) 100 claims 71% Sharps(medical and needle) 16% Body fluids
13 Worker s Compensation Statistics Which Residents most often sustain injuries/exposures? Resident Phys. II-VIII Resident Phys. 1 Hospital Admin. Resident
14 Must a Claim Be Filed for Needlesticks & Exposures Yes. Absent claim notification: The injured party will receive a bill(s) for service rendered There may be a delay in authorization of necessary treatment
15 What Steps Must be Taken When An Injury/Exposure Occurs A claim form must be completed by the injured party and/or the supervisor Employee and supervisor incident report forms can be found on the DMS website: - Employee - Supervisor The claim should be faxed within 24 hours of the date of notice to Disability Management:
16 Workers Compensation Processes: At OHS, they will give UC employees the Employee Incident Report (EIR) form At SFGH, Masa Rambo will give UC employees the Employee Incident Report (EIR) form If the employee is seen in the ER or by his/her own health care provider, UCSF will have no knowledge of the claim.
17 Important Contact Information Needlestick & Exposure Hotline 353-STIC(7842) Hotline Desk (do not use to report initial exposure) Occupational Health appointments Option 1 UCSF Campus Workers Compensation Sedgwick CMS claims reporting
18 If You Have Questions: About: Needlestick Hotline or treatment processes or protocols Call Erin Andersen: Worker s Compensation claim process, bill payments, reasonable accommodation Call Judy Rosen:
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