8
Management
Hospitals and Healthcare Facilities
In addition to the suggestions for institutions and professional schools,
healthcare facilities should do the following:
➤ Assure that HCP living with HBV, HCV, and/or HIV who do not perform
Category III/exposure-prone procedures are not prohibited from
participating in patient-care activities solely on the basis of their
infection(s).
➤ Ensure that all HCP follow all recommended and applicable infection
prevention precautions.
➤ Ensure that all HCP have the necessary training, personal protective
equipment and safer devices and equipment to be able to avoid
transfers of blood or other potentially infectious materials.
➤ Ensure that all HCP who perform or participate in Category III/
exposure-prone procedures are aware of the ethical obligation to
know their HBV, HCV, and HIV serologic/infection statuses.
➤ Provide all HCP who have potential for exposure to blood in the
healthcare workplace with an HBV vaccine series and assure that
vaccination has been successful, as measured by an anti-HBs
response.
➤ Provide HCP who either refuse to be vaccinated or fail to develop an
anti-HBs response after a second immunization series with access
to additional testing to assess the HCP's HBV status (e.g., HBsAg or
anti-HBc).
➤ Ensure that HCP who perform Category III/exposure-prone
procedures and who have not been, or cannot be, immunized with the
HBV vaccine are aware that they should undergo annual testing for
HBV to assure they are not infected. The Canadian guidelines
1
and the
UK guidelines
2
recommend annual and post-exposure testing.
➤ Create post-exposure management protocols for follow-up testing for
potential or known exposures to HBV, HCV, and HIV that occur during
the provision of healthcare.
➤ Confirm suspected HCV or HIV infection among HCP with virus-
specific RNA testing. Confirm suspected HBV infection with HBsAg
and/or HBV DNA testing.
