CDC guidelines highlight 'personnel health service'
December 1, 1997 3 minutes read
CDC guidelines highlight personnel health service’
Responsible for infection control among employees
Recent U.S. Centers for Disease Control and Prevention draft guidelines for infection control in health care workers hinge upon employee health services functioning as "an integral part of a health care organization’s general program for infection control."1 The comprehensive document clearly details the significant role of the "personnel health service" in carrying out all of the guidelines’ recommendations.
A hospital personnel health service usually encompasses the following infection control objectives, according to the CDC:
• educating personnel about infection control principles, stressing individual responsibility for infection control;
• collaborating with the infection control department in monitoring and investigating potentially harmful infectious exposures and outbreaks among HCWs;
• providing care to HCWs for work-related illnesses or exposures;
• identifying work-related infection risks and instituting appropriate preventive measures;
• containing costs by preventing infectious diseases that result in absenteeism and disability.
While the guidelines contain the CDC’s most definitive description and expectations of a hospital personnel health service’s responsibilities for HCW infection control, Elizabeth Bolyard, RN, MPH, CIC, epidemiologist in the CDC’s hospital infections program, says she has been "flabbergasted" to discover that the EHS in some U.S. hospitals is being downsized or eliminated altogether. She also is aware of HCW concerns that losing their in-house EHS could affect employee "closeness" with occupational health and impede continuing follow-up.
"Some hospitals are outsourcing their occupational health department," she says. "[CDC officials] have not discussed that, and we don’t have a specific recommendation, but our guidelines need to be carried out and done so appropriately."
To achieve infection control goals, the draft guidelines specify that personnel health services need to perform the following functions:
• Coordinate with other departments, including infection control, to help ensure adequate surveillance of employee infections, preventive services, and investigations of exposures and outbreaks.
• Administer pre-placement medical evaluations to ensure appropriate job placement. This includes a health inventory that determines immunization status, medical history that might predispose employees to acquiring or transmitting communicable diseases, and TB risk factors or treatment. It also includes a physical examination and screening, as well as periodic evaluations.
• Provide health and safety education to promote compliance with infection control programs. This includes clearly written policies, guidelines, procedures, and educational materials; it should be modified by employees’ job category, educational level, literacy, and language.
• Offer immunization programs to ensure that personnel are immune to vaccine-preventable diseases. National immunization guidelines for health care personnel are provided by the U.S. Public Health Service’s Advisory Committee on Immunization Practices.
• Manage job-related illnesses and infectious disease exposures, including policies for work restrictions. Arrange for prompt diagnosis and management of job-related illnesses, and provide appropriate postexposure prophylaxis following occupational exposures.
• Counsel HCWs on infection risks related to employment or special conditions. Information should include infection risks and prevention; postexposure illness or adverse outcome risks; exposure management (including postexposure prophylaxis); and potential consequences for employee transmission to others.
• Maintain confidential personnel health records, including medical evaluations, immunizations, exposures, postexposure prophylaxis, and screening tests, preferably in a computerized database and in accordance with Occupational Safety and Health Administration record-keeping requirements.
The draft acknowledges that the organization of a personnel health service is affected by an institution’s size, number of employees, and services offered.
Reference
1. Department of Health and Human Services, Centers for Disease Control and Prevention. Draft guideline for infection control in health care personnel, 1997; notice. 62 Fed Reg 47,275 (1997).
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