HIV Post Exposure Procedures

The employee HIV Post- Exposure Chemoprophylaxis policy (exposure process) has been revised.  The main change involves the Needle Stick Kit which is located in the ED Acudose.  The new Kit will contain several oral medications.  These medications will be prescribed to employees who have had a significant exposure from an HIV infected patient.  I will post the actual policy on the education board.  However the information provided below is a general synopsis of the process.

If exposed to blood and or body fluids, the following process should be implemented:

·         Wash the affected area immediately

·         Notify Employee Health (during business hours) or the Administrative Nursing Supervisor (weekends or non- business hours).

·         Complete a First Injury Report and ID the source patient

o   This information (Injury Report and source patient information) is forwarded to Employee Health or the Administrative Supervisor.

o   The Employee Health Department or Administrative Supervisor will obtain consent from the source patient for serum HIV and hepatitis testing.

·         If the source patient is negative, no treatment is necessary for the exposed team member.

·         If the source patient is reactive for HIV, the team member will be directed to the ED for further treatment.

o   The ED physician will initiate treatment as soon possible, preferably between 1-2 hours post exposure, but within 4 hours.

o   A seven day supply of medications will be given to the team member from the ED Acu Dose

·         Team members will also be evaluated by an Infectious Disease physician within 7 days (employee Health will make the appointment).

Content of Needle Stick Kit

·         Seven tabs (7)  each of tenofovir 300 mg  and emtricitabine 200mg  (tenofovir and emtricitabine=Truvada)

·         Fourteen tabs (14 ) raltegravir (Isentress) 400 mg

Directions for use:

·         Tenofovir 300mg+emtricitabine 200mg.  Take one tablet each by mouth every day for 7 days.

·         Raltegravir 400mg (Isentress). Take one tablet by mouth twice daily for 7 days.

Please refer to the actual policy for additional details.

The Dr Mercado Issue

Apparently there is a Dr Carlos Mercado who is affiliated with CFIM that sees patients at Lake Bennett. These patients should be admitted to CFIM and NOT  to Dr A Ahmed.

Please be vigilant in obtaining now the first name to get the patient assigned to the correct attending. We will need to update the database as soon as possible.

Dr Carlos Mercado – CFIM

Dr Michael Mercado – Dr A Ahmed

Hospitalist Database

The Hospitalist Database PDF that had been on the desktop computers was a stale document that was not updated. Since we have no control over the desktop any longer, that link was replaced with a link to the website where you can access the most up to date database. Most of the desktops should have the username and password saved. If not, please “Check ” the save password box when logging in.

Thanks

Risk Management Pager

Good afternoon all,

  Effective Monday January 13, 2014, the risk management department will be able to be reached via pager from 8:30 am – 5:00 pm Monday through Friday.  The new pager number will be 407-983-3389.

  Please share with your staff.

  Please contact me if you have any further questions.

  Thanks

  Haresh Ramjas