CDC Updated Infection Control Guidelines for Health Care Workers (Oct. 2019)
IN THE NEWS
Target Audience:
- Leadership & management operational roles for those with occupational risk of infectious disease exposure(s) or even possible risk.
- All leadership & staff that are part of the occupational or medical services section of an agency, or is contracted with one that administers or provides occupational health services.
The CDC just published an update to the Guidelines for Infection Control in Health Care Personnel, 1998. One of the parts that was updated referred, in the 1998 document, to emergency-response personnel. And, while first responders do share many aspects of infection prevention and control activities with other health care providers, there are also parts that are specific to first responders, with even differences between types of first responders. As an example, any hospital area can be surprised by an unsuspected infectious disease, but typically only the ER/ED rapidly take all comers, often without any history or event presentation given before the first approach and initial intake exam, even if it’s only triage. That, however, is what prehospital providers, including law enforcement, confront perhaps several times a day. It’s a practical document and contains valid and thoughtful recommendations
If an agency has a good call taking/dispatch system in place, particularly with CAD and computer interface or monitoring, calls that might put responders at risk for a hazardous materials or a potentially infectious disease call, may include a pre-arrival warning that allows time to don appropriate PPE or standby, if adequate PPE is not assigned to the unit. More often, as it was during SARS, Anthrax, 2009 Pandemic Flu, or each and every day, the symptoms that might indicate an infectious disease (or other haz-mat incident) may not be conveyed, either because it was omitted because it wasn’t asked or because the caller was afraid information about a potential infection would change or halt the dispatch.
This document is an update of 4 sections of Part I of the Guideline for Infection Control in Health Care Personnel, 1998 and their corresponding recommendations in Part II:
- C. Infection Control Objectives for a Personnel Health Service
- D. Elements of a Personnel Health Service for Infection Control
- H. Emergency-Response Personnel
- J. The Americans With Disabilities Act
This includes all occupational health services such as HCP-specific vaccinations, potential infectious disease follow-up, pre and post exposure counseling and treatment, etc., as well as analysis of exposures and compliance. For some agencies that have few exposures, either because of its employees’ roles or size, many of the occupational medical services may be provided outside the organization. However, even if all occupational services are contracted out, those that are administrators and decision makers will need to be very familiar with this document to assure that the proper programs are in place, and those in the need of these services are quickly identified and referred, when needed, for immediate care. Those actually providing occupational health care, whether inside or outside of an agency, must be able to provide the services outlined in this updated document, as well as the original sections of the document from 1998 that are not superseded by the update.
Both documents make reference to emergency response personnel and special consideration needs, as well to provisions in the ADA (Americans with Disabilities Act) that apply to occupational health. All emergency response agencies should make sure that all exposures are being reported, including those where the determination of an exposure is unclear. Often, especially in those agencies that have little to no volume of occupational exposure risk, this is best done by partnering with local public health authorities, local hospitals with occupational and/or infection control sections or departments, and/or with larger systems that provide EMS service in a community, and therefore likely have provision for initial identification and exposure mitigation procedures and trained staff to initiate the process. It is important to note that this document also covers unpaid health care providers such as, but not limited to, volunteers and students.
At times, some emergency responders may be part time health care personnel while other times are fulfilling another more typical role. Two that come to mind are the police officers (or other law enforcement) and some firefighters, both of whom have first responder roles until more advanced EMS responders take over. When they are providing medical care such as ABCs, bleeding control, wound care, CPR, etc., they are captured under the health care personnel umbrella and therefore, are covered by these documents.
Links to the Complete Document and Individual Sections:
Infection Control in Healthcare Personnel: Infrastructure and Routine Practices for Occupational Infection Prevention and Control Services (Updated October, 2019):
https://www.cdc.gov/infectioncontrol/guidelines/healthcare-personnel/index.html
Executive Summary:
https://www.cdc.gov/infectioncontrol/guidelines/healthcare-personnel/exec-summary.html?deliveryName=USCDC_425-DHQP-DM11130
Authors, Citations, Disclosures & Disclaimers:
https://www.cdc.gov/infectioncontrol/guidelines/healthcare-personnel/authors.html
Terminology with Glossary, Acronyms & Abbreviations:
https://www.cdc.gov/infectioncontrol/guidelines/healthcare-personnel/appendix/terminology.html
Introduction:
https://www.cdc.gov/infectioncontrol/guidelines/healthcare-personnel/introduction.html
Management & Leadership:
https://www.cdc.gov/infectioncontrol/guidelines/healthcare-personnel/leadership.html
Communication & Collaboration:
https://www.cdc.gov/infectioncontrol/guidelines/healthcare-personnel/communication.html
Assessment & Reduction of Risk for Infection Among HCPs: https://www.cdc.gov/infectioncontrol/guidelines/healthcare-personnel/assessment.html
Medical Evaluations:
https://www.cdc.gov/infectioncontrol/guidelines/healthcare-personnel/evaluation.html
Occupational Prevention Infection Control – Training & Education:
https://www.cdc.gov/infectioncontrol/guidelines/healthcare-personnel/training.html
Immunization Programs:
https://www.cdc.gov/infectioncontrol/guidelines/healthcare-personnel/immunization.html
Management of Potentially Infectious Exposures & Illnesses:
https://www.cdc.gov/infectioncontrol/guidelines/healthcare-personnel/exposures.html
Management of HCPs’ Health Care Records:
https://www.cdc.gov/infectioncontrol/guidelines/healthcare-personnel/health-records.html
Appendices:
https://www.cdc.gov/infectioncontrol/guidelines/healthcare-personnel/appendix/index.html
Other Resources and Links:
Updated U.S. Public Health Service guidelines for the management of occupational exposures to HIV and recommendations for postexposure prophylaxis. 9/25/13 (May 23, 2018)
https://stacks.cdc.gov/view/cdc/20711
NIOSH Revised/Updated Resources to Help Prevent Exposures to Emergency Response Employees to Infectious Diseases During Duty (11/2/11):
https://www.cdc.gov/niosh/updates/upd-11-02-11.html
Core Infection Prevention and Control Practices for Safe Healthcare Delivery in All Settings –Recommendations of the HICPAC (Healthcare Infection Control Practices Advisory Committee)
https://www.cdc.gov/hicpac/recommendations/core-practices.html
OSHA Bloodborne Pathogens:
https://www.osha.gov/laws-regs/regulations/standardnumber/1910/1910.1030
OSHA Respiratory Program – General Requirements:
https://www.osha.gov/laws-regs/regulations/standardnumber/1910/1910.132
OSHA Respiratory Program – PPE Respiratory Protection:
https://www.osha.gov/pls/oshaweb/owadisp.show_document?p_id=12716&p_table=STANDARDS
Updated U.S. Public Health Service guidelines for the management of occupational exposures to HIV and recommendations for postexposure prophylaxis. 9/25/13 (May 23, 2018)
https://stacks.cdc.gov/view/cdc/20711
CDC Hepatitis B Virus Facts for Healthcare Professionals:
https://www.cdc.gov/hepatitis/hbv/hbvfaq.htm
CDC Hepatitis C Virus Facts for Healthcare Professionals:
https://www.cdc.gov/hepatitis/hcv/hcvfaq.
