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Clinical Practice Guideline for an Infection Control/Exposure Control Program in the Oral Healthcare Setting
Post-exposure Evaluation and Follow-up

Course Author(s): Géza T. Terézhalmy, DDS, MA

Post-exposure Evaluation and Follow-up

Following an exposure to blood or OPIM, OHCPs shall immediately undergo a confidential medical evaluation and subsequent follow-up by a qualified health-care professional in accordance with current recommendations of the U.S. Public Health Service.

  1. Background

    2. Exposure to blood or OPIM, including saliva (even when blood is not visible), must be considered potentially infectious. Consequently, post-exposure evaluation and follow-up is a critical element of a comprehensive infection control/exposure control protocol.

  2. Execution/Compliance
    1. Immediately after an exposure incident
      1. Wash injuries with soap and water and apply an antiseptic agent (if available).
      2. Report the exposure incident immediately to the Office Infection-control Officer or other designated person.
      3. Complete the Uniform Needlestick and Sharp Object Injury Report Form.
    2. Within 2 hours of exposure and with the consent of the OHCP, arrangements are made for a post-exposure evaluation by a physician who will be provided with the following information:
      1. A copy of the completed Uniform Needlestick and Sharp Object Injury Report Form.
      2. A copy of the OHCPs Medical Record (see Figure 1. below).
      3. Any information available about the source individual.
        1. With the source person’s consent, the source person’s blood is tested as soon as feasible to determine hepatitis B and C virus, and HIV infectivity.
        2. Results of the source person’s testing are made available to the OHCP
        3. The OHCP is informed of the applicable laws and regulations concerning the disclosure of the identity and infectious status of the source person.
      4. Post-exposure management and prophylaxis.
        1. After percutaneous, mucous membrane, or non-intact skin exposure to blood or OPIM, the consulting physician will initiate post-exposure management (prophylaxis) according to the latest CDC recommendations.
        2. The consulting physician’s written report is obtained within 15 days of the post-exposure evaluation and is made available to the OHCP.
      5. A medical record is maintained on every OHCP, which includes the following information:
        1. Vaccination status
          1. Dates of vaccinations (where appropriate or available).
          2. Evidence of immunity (where applicable or available).
          3. Documentation relative to the individual’s inability to receive the vaccinations required or highly recommended.
          4. A signed copy of the mandatory hepatitis B vaccination declaration form (See II. Vaccinations).
        2. A copy of all results of examinations, medical testing, and other post-exposure follow-up procedures.
        3. The medical record is available for examination by the OHCP and a copy is provided upon request.
          1. The content is confidential and is not disclosed to anyone, without the OHCP’s expressed written consent, except as require by law.
Figure 1. Uniform Needlestick and Sharp Object Injury Report Form.
Image: Uniform Needlestick and Sharp Object Injury Report Form.
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