Graduate Medical Education

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OCCUPATIONAL HEALTH SERVICES  

The Occupational Health program is managed through MCW Occupational Health Services (MCWOHS).  The Clinic is located on the first floor of the Froedtert Specialty Clinic building, Suite 1996, across from registration.  Its hours are Monday – Friday, 8:00 am – 4:30 pm.  Telephone number is (414) 805-6699. You may call to schedule an appointment for Hepatitis B vaccine, MMR, TB skin tests, influenza vaccine, respirator fit testing, chicken pox vaccine and serology required by the affiliated hospitals. MCWOHS will provide a repository for occupational health, training and exposure records.  All records are kept in a confidential manner.  There is no cost to housestaff.

MCWAH housestaff will have the option of receiving their PPD and other tests through the affiliated hospitals or MCWOHS.  MCWOHS requests a copy of your record if tests or vaccines are provided at an affiliated hospital.  You may fax records to (414) 805-6698.  Please contact MCWOHS to schedule an appointment at (414) 805-6699.  If you have a safety concern or occupational health questions, call (414) 805-6699.  OSHA compliance training will also be provided through MCWOHS.

Blood/Body Fluid Exposure Protocol 

Individuals exposed to blood or body fluids are at risk of HIV infection. Although preventing blood exposure is the primary means of preventing occupationally acquired infections, appropriate post exposure management is an important factor for workplace safety. Information suggesting that post-exposure prophylaxis medication immediately following high-risk occupational blood/body fluid exposure has been associated with a decrease in HIV seroconversions.

During the hours of operations (Monday-Friday, 8:00 am to 4:30 pm), MCW Occupational/ Employee Health will evaluate exposures to blood and body fluids to determine appropriate post exposure management.  If the MCW Occupational/Employee Health Clinic is unavailable,housestaff should go either to the Employee Health Department of their affiliated hospital or to the emergency room at the closest affiliated hospital.  If at Froedtert Hospital and the exposure occurs after hours or on the weekend, the housestaff member should contact the Froedtert administrative representative for assistance.

The procedure is as follows:

A. All individuals with a potential blood or body fluid exposure will be evaluated using Public Health Service recommendations to determine    whether a significant exposure has occurred, the degree of risk associated with the exposure, and what type, if any, of postexposure prophylaxis (PEP) is appropriate.

B. If it is determined that no significant exposure has occurred, PEP will not be offered. Exposures to other body fluids will be evaluated and treated according to accepted practices.

C. If exposure is determined to be high-risk and PEP is initiated, the following is required:

1. Laboratory testing of the exposed employee (in addition to exposure panel) to include: a. CBC with differential b. ALT (SGOT) c. Chem Panel d. Pregnancy (stat serum) if indicated

2. All of the above tests will be ordered on a standard laboratory order form and sent to the lab. Confidentiality of all MCWAH housestaff exposures will be maintained.

3. Counseling for exposed person: a. Statistical exposure information b. PEP medication information (risks vs. benefits) (medical information sheets) c. Post-exposure transmission prevention d. Assurance of confidentiality e. Referral to Infectious Disease, if pregnant or otherwise indicated.

4. A medical history review will be completed.

5. Copy of MCWAH Resident Incident Report will be sent to the MCW Occupational Health Specialist at MCW Occupational Health Clinic, 9200 West Wisconsin Avenue, Suite 1996, Milwaukee, 53226.

D. A 2-day (or 4-day if exposure occurs on Friday) supply of prescribed PEP medications will be given to the exposed person to be taken until:

1. The exposure source is determined to be HIV Negative.

2. The exposed person is able to obtain additional meds from a pharmacy.

E. In the event the source is known or determined to be HIV infectious, a written prescription for 1-2 weeks of PEP meds will be given to the exposed person to fill at the pharmacy.

F. MCWAH will be responsible for cost of PEP medications and lab testing.

G. Follow-up visits will be scheduled with MCW Occupational Health every 1-2 weeks during PEP therapy. These visits will include:Review of Side Effects

1. Lab testing at 2 wks: CBC, Metabolic Panel.  Lab testing at 4 weeks: CBC and Metabolic Panel. Lab testing at 6 wks: CBC, Metabolic Panel, and HIV ELISA. Lab testing at 3 months:HIV ELISA. Lab testing at 6 months: HIV ELISA and ALT.

H. Decision to discontinue PEP prior to completion of therapy will be determined by the clinical provider in collaboration with the MCW
    Occupational Health Services Medical Director and/or the MCW Chief of Infectious Disease when medically indicated.

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Page Updated 12/19/2013