Managing Exposure Incidents in the Healthcare Setting

Exposure incidents pose significant risks within healthcare environments. Understanding the steps to take following exposure to bloodborne pathogens is crucial for employee safety and infection control.

Definition of an Exposure Incident

Key Definition: An exposure incident involves contact with blood or potentially infectious materials through mucous membranes, broken skin, or punctures, occurring during an employee's work-related duties.

Immediate Actions Post-Exposure

• Decontamination: Immediately cleanse the affected area to reduce the risk of infection.
• Medical Treatment: Seek prompt medical evaluation and treatment without delay for paperwork.
• Reporting: Report the incident to your supervisor and follow your employer’s procedures for documentation and further action.

The Two-Hour Rule for Reporting

Reporting Timeline: Report and complete necessary documentation within two hours of the incident. Prioritise medical treatment over paperwork if needed.

Follow-Up and Preventive Treatment

Healthcare workers exposed to HBV or HIV should receive expedited post-exposure treatment. Pre-consideration of preventative treatments for high-risk individuals is advised to ensure rapid initiation of antiretroviral therapy when needed.

Exposure Control Plan

Plan Requirements: Employers must have an exposure control plan detailing prevention, treatment, and follow-up steps for accidental exposure to bloodborne pathogens.

Designated Healthcare Professionals

NHS Trusts should designate physicians for immediate consultation following an exposure incident. Occupational Health services should play a key role in managing post-exposure procedures.

Access to Expert Advice

Consultants in virology, microbiology, and infectious diseases should be considered for expert advice. Occupational Health services are crucial for expedited delivery of preventative medications.

Support for Exposed Employees

Information, counselling, and psychological support should be available for employees post-exposure. Early testing and a follow-up at six months are recommended to exclude infection transmission.

Post-Exposure Treatment Guidelines

Designated physicians should stay informed on the latest guidelines for post-exposure treatment, including the use of hepatitis B vaccines and antiretroviral drugs for HIV exposure.

After-Hours Support

An appropriate professional should be available outside of normal working hours for advice and treatment of significant occupational exposures, equipped with the health authority's policy on exposure management.