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Occupational health services (OHS) keep the health records of a healthcare organization's own staff — healthcare personnel (HCP) — so they can prevent and control infection among them. Done well, a record system lets OHS answer an outbreak in minutes ("who here is immune to measles?") and spot trends in staff exposures and illness. This is section 8 of Part I (Infrastructure and Routine Practices) of CDC's guideline Infection Control in Healthcare Personnel.
What goes in the record
Information from pre-placement, periodic and episodic medical evaluations, whether OHS did them or an outside provider did:
- infectious disease screening related to the job;
- evidence of immunity to vaccine-preventable diseases;
- immunizations offered and given;
- exposure and illness management;
- counseling;
- work restrictions.
Recommendations for leaders and administrators
| No. | Recommendation |
|---|---|
| 8.a | Set up systems — preferably electronic — for confidential, work-related staff health records that: |
| 8.a.1 | let only authorized people in; |
| 8.a.2 | give authorized clinicians fast access; |
| 8.a.3 | make it easy to combine and de-identify data; |
| 8.a.4 | allow tracking of trends in infectious risks, screening tests, exposures and infections; |
| 8.a.5 | allow confidential reporting to people and departments inside the organization and to outside groups. |
| 8.b | Consider electronic features that: |
| 8.b.1 | alert OHS when a staff member's infection prevention and control services are due; |
| 8.b.2 | share work restrictions with the organization's other data systems, such as human resources. |
Recommendations for occupational health staff
| No. | Recommendation |
|---|---|
| 8.c | Help write the policies and plans for exchanging staff health information confidentially and efficiently. |
| 8.d | Keep records and databases covering medical evaluations, infectious disease screening, evidence of immunity and immunizations, exposure and illness management, and work restrictions. |
| 8.e | When sharing records, keep them confidential, get the right authorizations and give only what is needed. |
| 8.f | Give staff copies of their own records promptly when they ask — preferably within 15 days. |
What electronic records add
An electronic health record (EHR) or similar system can:
- raise alerts automatically — for follow-up after an exposure, an immunization that's due, or another service;
- pull in information other departments enter, such as work restrictions from human resources, so decisions about a staff member can be shared;
- speed up mandated reporting of immunization data and analysis of vaccination coverage, and support risk reduction and quality improvement;
- record vaccine contraindications better, preventing mistakes such as vaccinating someone who reported a reason not to be.
Required documentation
The Occupational Safety and Health Administration (OSHA) requires employers to create and keep employee medical records on occupational exposures and infections, keep them confidential and give employees their records on request. In particular:
| OSHA form or standard | What it requires |
|---|---|
| OSHA 301, "Injury and Illness Report" | recording certain work-related injuries and illnesses |
| OSHA 300, "Log of Work-Related Injury and Illnesses" | keeping a running log |
| OSHA 300A, "Summary of Work-Related Injury and Illnesses" | completing an annual summary |
| Respiratory Protection standard | documenting medical clearance and other services for respirator use |
Other federal, state and local rules may also apply.
Reporting
OHS may have to report aggregated, de-identified staff health data — often electronically — to people inside the organization, such as infection prevention and control staff and senior management, and to outside bodies such as the National Healthcare Safety Network (NHSN).
Confidentiality and security
Protecting staff health information keeps the organization compliant and builds staff trust in OHS.
- Define who may open staff health records, which makes access limits enforceable.
- Keep staff records apart from patient records. Storing them in the same system as patient care information risks staff seeing colleagues' private details; some organizations use separate paper files or separate electronic systems, and state or local rules may require separation.
- The 1996 HIPAA Privacy Rule (Health Insurance Portability and Accountability Act) protects identifiable health information held by covered entities and their business associates and gives patients rights over it. Asking for or handing over a staff member's medical records may need HIPAA-compliant consent, depending on why and to whom.
Sources
Based on "8. Management of Healthcare Personnel Health Records," Infection Control in Healthcare Personnel, Part I, Centers for Disease Control and Prevention; a work of the United States government in the public domain. The source's item 8.g repeats the wording of 8.a.4 and is not listed separately here.
Лицензия: CC0 1.0 (общественное достояние) · По материалам www.cdc.gov
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