Ask the expert: Source patient testing after needlestick injury

By: February 3rd, 2012 Email This Post Print This Post

Q: When must we obtain testing consent from the source individual after an employee needlestick exposure?

A: The sooner the better.

Section 1910.1030(f)(3)(ii)(A) of the Bloodborne Pathogens standard says, “The source individual’s blood shall be tested as soon as feasible and after consent is obtained.” If consent cannot be obtained, OSHA requires you to document as such.

Also, if you are in a state where the source individual’s consent is not required, “the source individual’s blood, if available, shall be tested and the results documented,” according to the standard.

Comments

By Ajaz Fakhri on February 4th, 2012 at 10:59 pm

Kindly comment if you are doing different tests:
Source patient:HBsAg,AntiHCV,HIV 1/2 antibodies
Staff tests(recepient):HBsAg,AntiHCV,HIV 1/2 antibodies and HBsAg antibodies,ALT(alanine transaminase)
This is our part of protocols and documented on needle stick injury form

We do an ALT level on the source as well.

We do not complete HBsAg on the employee. We will complete a HBsAb if their immunity status is unknown.

By Bruce Cunha on February 7th, 2012 at 9:28 am

Same here. Only test the employee if no positive titer on file. Remember, per the OSHA BBP standard, you are supposed to test your employees after vaccination.

We only run additional tests on the source if the initial tests come back positive.

On our admission consent forms we have a blurb saying they also consent to have their blood drawn for testing if an exposure occurs along w/ all the other things they consent to. That way, if a needlestick occurs alls we have to do is look back to see if they signed their admission consent and if they did, we are good to go. Just a suggestion for others to make the process a little easier.

I work in an “opt-in” state that requires a separate consent for HIV testing. I urge all my employees to report the incident before the patient has been discharged from the office so that we can obtain the consent and the blood and start the rapid HIV testing of the source patient. Our goal is to have the rapid HIV results within 2 hours. Even though we do the rapid HIV, we automatically follow it up with a confirmatory test.

 

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