NEW 2017 OSHA RECORDKEEPING REPORTING REQUIREMENTS & THE IMPACT ON EXPOSURE TO BLOOD AND BODY FLUIDS 2017A005 Amber H Mitchell, DrPH, MPH, CPH
Disclosure: In accordance with the policies on disclosure of the Accreditation Council for the American Nurses Credentialing Center s Commission on Accreditation (ANCC), the American Academy of Family Physicians (AAFP), The Commission for Case Manager Certification (CCMC), all planner and presenters for this conference have been asked and are expected to identify whether they do or do not have any real or apparent conflict(s) of interest or other relationships related to the content of their presentations(s). Conflicts of Interest A conflict of interest occurs when an individual has an opportunity to affect educational content about health-care products or services of a commercial company with which he/she has a financial, professionals, or personal relationship. DISCLAIMER Association of Occupational Health Professionals in Healthcare (AOHP) acknowledges the operational requirements of credentialing organizations. The sponsors of continuing education activities and the presenter(s) at these activities disclose significant relationships with commercial companies whose products or services are discussed in educational presentations. Disclosure of a relationship is not intended to suggest or condone bias in any presentation, but is made to provide participants with information that might be of potential importance to their evaluation of a presentation. All presenters have completed a Faculty Disclosure Form to AOHP. Presenter(s) will deliver a disclosure statement indicating if they have any commercial affiliation to the audience. The information presented at this conference represents the views and opinions of the individual presenters, and does not constitute the opinion or endorsement of, or promotion by, the Association of Occupational Professionals in Healthcare (AOHP). Reasonable efforts have been taken intending for educational subject matter to be presented in a balanced, unbiased fashion and in compliance with accreditation/regulatory requirements. However, each program attendee must always use his/her own personal and professional judgment when considering further application of this information. Association of Occupational Health Professionals in Healthcare is an accredited provider of continuing nursing education by the American Nurses Credentialing Center's Commission on Accreditation.
Provide Describe the current prevalence of bloodborne disease (HIV, HBV, HCV) and the impact on occupational exposures in healthcare Summarize Provide Summarize current occupational incident surveillance data regarding exposures to blood and other potentially infectious materials (OPIM) from EPINet Provide guidance on the impact of new OSHA Recordkeeping submission requirements on targeted compliance for the use of PPE and engineering controls LEARNING OBJECTIVES Create Create renewed focus on building more effective occupational infectious disease prevention programs by providing immediately actionable data, tools and resources
DISCUSSION QUESTIONS 1. Will OSHA Present National Data? If So, How? When? 2. Will Data be Meaningful for Intervention and Change? 3. Will You Use Your Data to Recruit/Retain New Staff, Patients? 4. Is your Data Actionable Now? 5. Does your data allow you to Build Successful Infectious Disease and Bloodborne Pathogen Prevention Programs? 6. How Would You Use Your Data to Improve Accessibility to and Use of PPE, Engineering Controls, Safer Devices, and Safe Work Practices? 7. What Would you Change/Add to Current Recordkeeping/Report Forms?
WHY IS OCCUPATIONAL EXPOSURE TO BLOOD & BODY FLUID STILL A PROBLEM? How are risks different than before? 5
HEPATITIS B VIRUS (HBV) GLOBALLY: 2 3 BILLION PEOPLE OF WHICH MILLION REFUGEES REF: MMWR June 5, 2015/64(21);570-573 Section slides borrowed from 08/01 International Safety Center/BD/Schein Webinar 6
HEPATITIS C VIRUS (HCV) CDC Warns on Rising Cases of Hepatitis C REF: Wall Street Journal, May 8, 2015 and HCV Epidemiology in the US 7
HEPATITIS C VIRUS (HCV) Hepatitis C killed almost 20,000 Americans in 2013. More of us died from hepatitis C than from 60 other infectious diseases combined... REF: CDC Press Release May 4, 2016 8
HCV RATES COMPARED TO NATIONAL GOALS REF: https://www.cdc.gov/hepatitis/statistics/2015surveillance/index.htm
HUMAN IMMUNODEFICIENCY VIRUS (HIV) Today, 1.1 MILLION PEOPLE in the US are living with HIV. Don t know they are infected 1in7 and can pass the virus to others. REF: CDC https://www.cdc.gov/hiv/statistics/overview/ataglance.html 10
HIV IN THE US BY GEOGRAPHY REF: https://aidsvu.org/
RISK OF CO-INFECTION People with HIV infection are often affected by chronic viral hepatitis, including: - HBV and/or HCV, and - Co-infection with a multi-drug resistant organism like MRSA REF: CDC HIV and Viral Hepatitis Factsheet, 2016 12
Emerging Infectious Disease Exposures
OSHA RECORDKEEPING REQUIREMENTS What s New! 14
NEW REQUIREMENT FOR ELECTRONIC SUBMISSION Beginning in 2017 REF: https://www.osha.gov/recordkeeping/finalrule/ 15
FINAL RULE TO IMPROVE TRACKING OF WORKPLACE INJURIES AND ILLNESSES public disclosure of the data will nudge employers to reduce work-related injuries and illnesses in order to demonstrate. safe and healthy work environments for their employees. 16
UNIQUE REQUIREMENTS FOR SHARP INJURY, EXPOSURE TESTING & SEROCONVERSION OSHA Recordkeeping 300, 300A Instructions Available: https://www.osha.gov/recordkeeping/ new-osha300form1-1-04.pdf Privacy Information: Access to Employee Exposure and Medical Records Standard https://www.osha.gov/pls/oshaweb/o wadisp.show_document?p_table=stan DARDS&p_id=10027 17
UNIQUE RECORDKEEPING REQUIREMENT OF THE OSHA BLOODBORNE PATHOGENS STANDARD (2001 REVISION) Why might this not be enough to be actionable? What might you add? Edit? 18
EPINET SUMMARY DATA
PLACEHOLDER FOR 2016 EPINET SUMMARY DATA
INJURY & EXPOSURE TRENDS OVER TIME Are We Headed in the Right Direction Despite all We Know?
HIGHEST PREVALENCE BY PROCEDURE TYPE, 2000-2011 Mitchell et al. Journal of Hospital Infection, 2017
SHARP OBJECT INJURY SAFETY COMPARED TO NON-SAFETY, 2000-2011 Mitchell et al. Journal of Hospital Infection, 2017
250 Blood & Body Fluid Exposures Compared to Eye ONLY, Eye Protection Use 2012-2014 200 150 100 50 0 2012 2013 2014 Total Incidents # to Eyes # Wearing Eye-Appropriate PPE A Mitchell, AOHP Poster 2016
A Mitchell, OR Manager Poster 2016
Percent of Nurses, Eye Protection Use, and Location, EPINet 2013-2015 A Mitchell, AAOHN Poster 2016
POTENTIAL IMPACT OF NEW REPORTING REQUIREMENTS ON BLOOD & BODY FLUID EXPOSURES GROUP DISCUSSION
PLACEHOLDER FOR GROUP DISCUSSIONS
CRITICAL CONSIDERATIONS FOR NATIONAL DATA ois system user friendly enough to promote ease of submission? What about smaller employers that keep paper records? oenough information being collected so that we can prevent future injuries, exposures? owill data be delivered and/or presented to the public? How timely? What will be reported/presented? owill there be checks/balances for adequacy of data? Promote under-reporting? oif seroconversions are not identified in response to a sharps injury/needlestick/bbf exposure will we assume there are none? oothers?
WHAT WOULD YOU ADD OR EDIT? oto the Sharps Injury Log? oblood & Body Fluid Exposures? Mucotaneous Exposures? oppe Use and/or Compliance? ohow to link Infection/ Illness/Seroconversion to an Event/Injury/Exposure?
Amber.Mitchell@internationalsafetycenter.org To Get EPINet: www.internationalsafetycenter.org To Become an EPINet Network Facility, Email Ginger.Parker@internationalsafetycenter.org THANK YOU! QUESTIONS?