Infection Control in Healthcare Personnel
What to know
- Guideline: Infection Control in Healthcare Personnel
- Segment: Part I Infrastructure and Routine Practices
- Summary: Recommendations and resources for the assessment and reduction of risks for infection among healthcare personnel.
Additional Recommendations
See section 1. Leadership and Management for additional related recommendations.
For healthcare organization leaders and administrators
Number
Recommendation
3.a.
Regularly meet with occupational health services leaders to review results of risk assessments related to occupational infection prevention and control, set performance goals, and charge relevant healthcare organization departments and individuals to reduce risks.
For occupational health services leaders and staff
Number
Recommendation
3.b.
Conduct, or collaborate with other healthcare organization departments or individuals in, regular risk assessments and risk reduction activities related to occupational infection prevention and control.
3.c.
Notify healthcare organization leaders and departments about hazards identified and risk reduction plans, progress, and priorities for healthcare personnel.
Background
HCP are at risk of infectious exposures in the workplace that vary depending on their job duties and other factors
Approaches to risk assessment and reduction
Depending on HCO management structure and type of risk, OHS may lead some risk assessment and reduction activities or collaborate with other HCO departments, such as IPC services, that lead these efforts (see section 2. Communication and Collaboration). Such activities could include improving access to services by providing resources at off-site job locations during work hours, or working with supply management counterparts to ensure HCP access to correct PPE. Box 3. Examples of Hazard Identification, Risk Assessment, and Risk Reduction Activities lists examples of risk assessments and reduction strategies that might commonly involve OHS.
Controlling exposures to occupational infections is a fundamental method of protecting HCP. Traditionally, a hierarchy of controls (Figure 1. Hierarchy of Controls) has been used as a means of determining how to implement feasible and effective control solutions
Abbreviations
- CoP = Conditions of Participation
- HCO = Healthcare Organization
- HCP = Healthcare Personnel
- IPC = Infection Prevention and Control
- NHSN = National Healthcare Safety Network
- OHS = Occupational Health Services
- OSHA = Occupational Safety and Health Administration
- PPE = Personal Protective Equipment
- TB = Tuberculosis
Selected requirements related to the assessment and reduction of occupational infection risks
Occupational IPC assessment activities are supported or required by federal, state, or local regulations, payers, and accreditation agencies. Requirements include, but are not limited to:
- OSHA requires HCO to maintain logs of work-related injuries and illnesses meeting certain criteria, including infectious diseases exposures
- OSHA requires employers to conduct workplace evaluations to assess implementation of an Exposure Control plan for all affected employees
- OSHA requires employers to evaluate respiratory hazards in the workplace, and to implement a respiratory protection program, if needed
- CMS requires that some HCOs report HCP influenza immunization coverage to the National Healthcare Safety Network (NHSN) as a CoP
- The Joint Commission standards require establishing an influenza vaccination program for staff, setting incremental vaccination goals to increase coverage, and reporting HCP influenza immunization rates to key stakeholders
OSHA further supports risk assessment and reduction activities with online information and tools, including a job hazard analysis booklet and "eTools" about workplace health and safety topics
Box 3. Examples of Hazard Identification, Risk Assessment, and Risk Reduction Activities in which Occupational Health Services Might Participate
| Possible Hazard(s) Identified | Example Assessment Method | Risk Reduction Plan Example (Control Addressed) [ a ] |
|---|---|---|
| Sharps injuries among surgeons when suturing fascia with sharp suture needles | Review of logs of sharps injuries (e.g., OSHA 300 forms) | Revise HCO policies (e.g., HCO equipment purchasing, operating room procedures) to use blunt-tipped suture needles for suturing fascia (elimination/substitution) |
| Sharps injuries on a single unit/floor linked to inconvenient sharps container placement | Review of logs of sharps injuries (e.g., OSHA 300 forms) | Move sharps containers to accessible locations (engineering control) |
| Sharps injuries among HCP using a newly introduced syringe with a sharps safety feature; HCP reported no training on using the new device | Review of logs of sharps injuries (e.g., OSHA 300 forms) | Develop procedures for HCP training on new products prior to use (administrative control) |
| Lowest influenza immunization coverage among HCP in an outpatient, free-standing facility; immunizations were not offered on-site | Review of HCP immunization records and interviews with HCP | Offer on-site immunization of HCP at outpatient sites during work hours (administrative control) |
| HCP TB infections over the past 6 months on one hospital unit | Review of HCP health records and interviews with HCP | Repair of malfunctioning negative pressure in an airborne infection isolation room (engineering control) |
| HCP who presented to OHS over the past 6 months had come to work when already ill; reasons included fear of consequences for missing work and lack of paid sick leave | Review of HCP health records and interviews with HCP | Revise sick leave policies to ensure they are non-punitive and inform HCP of the changes (administrative control) |
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