Recorded on May 23, 2023 1 pm – 2 pm Eastern
Post-Exposure Investigation from the Infection Prevention View
By Laura J. Markman, RN-BC, MS
Health care environments can present a variety of hazards to both clinical and non-clinical employees. While many are infectious in nature, some may involve biohazardous waste and still others can be chemical in nature. All can result in an exposure investigation to determine who is at risk for acquiring an illness or being harmed if the exposure is not stopped. And in the case of an infectious exposure, the goal is to prevent an outbreak. A sound process to completing an exposure work up is paramount to stopping the spread of infection or other harm. A detailed definition is key to this process and its development requires a team approach. These teams can include Infection Prevention and Control, Safety, Engineering or another department depending upon the hazard. The initial definition may need to be revised several times during the course of the exposure investigation. Being exact in the definition also helps prevent overwhelming the Occupational Health staff, and laboratory staff (if lab follow up is required) as it narrows who needs to be part of the investigation. Tools such as concentric circles and excel spread sheets help maintain the focus on the definition as well as assist in identifying when the definition needs to be revised.
Additional factors that need to be considered in an exposure work up include how to maintain employee privacy and how to handle the “worried well”. These are employees who do not meet the working exposure definition but are convinced they have been exposed and are constantly calling to be part of the exposure investigation.
And last, it is critical to evaluate the results to identify and implement work place changes to prevent similar exposures as well as the process so that the next exposure investigation goes that much smoother.
1.Describe how to develop a definition for the exposure
2.Identify tools that can be used to further refine the exposure definition and what their role would be.
3.Identify and discuss additional factors in an exposure investigation and methods to mitigate them.
4.Discuss what should be included in evaluating the exposure investigation.
Ms. Markman has over 38 years of practice as a Registered Nurse with the last 16 in Infection Control. She holds a Bachelor’s Degree in Nursing and a Master’s Degree in Nursing Administration. She is certified in Med/Surg Nursing.
Ms. Markman is the Director of Infection Prevention and Control at the VA Palo Alto Health Care System. She was the 2020 recipient of the VA Under Secretary’s Linda Danko Award for Excellence in Infection Prevention and Control.
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Type of Activity: Knowledge
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Continuing education Contact Hour: This activity awards one (1) contact hour.
Provider approved by the California Board of Registered Nursing, Provider Number CEP 17664.
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