STI Clinic: Bloodborne Incident Case

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The risk of being exposed to infectious materials is high among workers in the sphere of healthcare. Thus, the minimization of occupational exposure to blood-borne pathogens is a task for the managerial control in healthcare facilities because blood-borne pathogens cause the development of such diseases as Hepatitis B, Hepatitis C, and HIV/AIDS (Byrd, Lu, & Murphy, 2013, p. 499). According to the U.S. Occupational Safety and Health Administration (OSHA) standards and regulations, employers are responsible for identifying risks and developing procedures to decrease the risks of exposure to blood-borne pathogens (LaMontagne, Oakes, & Lopez Turley, 2004, p. 1615).

The blood-borne incident in an STI clinic demonstrates the necessity of focusing on the discussion of the problem in terms of the management’s effectiveness (Buchbinder, Shanks, & Buchbinder, 2013, p. 103). The situation when a housekeeper in a clinic can be exposed to blood-borne pathogens is typical, and it is important to determine three management issues that are associated with the problem of occupational exposure in an STI clinic. The management issues that need to be discussed in detail are the administration of occupational exposure risks; the guarantee of the employee and patient safety; and the compensation issue.

Background Information

An STI clinic is an organization connected with Best Medical Center, and employee transferals are possible between these healthcare organizations. Maria Ortiz was transferred to an STI clinic after working for Best Medical Center as a housekeeper in the non-clinical areas. During a seven-day period after the transferal, Maria pricked herself with a needle that was dirty, and she was infected with Hepatitis B. While working at Best Medical Center, Maria was not provided with the training on blood-borne pathogens, and the woman was not trained at an STI clinic (Buchbinder et al., 2013, p. 103). As a result, the management of an STI clinic faced such problems as the determination of persons responsible for the incident, the treatment costs issue, and the employee occupational safety issue.

Administration of Occupational Exposure Risks

The main responsibility of the employer associated with decreasing risks of exposure and declared by the principles of the OSHA regulations is the provision of the initial and annual training for employees having a risk of exposure to blood-borne pathogens (Byrd et al., 2013, p. 499). While focusing on a case in an STI clinic, it is important to state that the supervisor in a clinic violated the OSHA regulations while assuming that Maria as a housekeeper could have the training on blood-borne pathogens provided by Best Medical Center because the employer was obligatory to organize the initial training for new employees after the transferal (Buchbinder et al., 2013, p. 103).

In addition, Mehrdad, Meshki, and Pouryagub (2013) note that according to the OSHA guidelines, an employee is not responsible for knowing the aspects of occupational exposure before the training is conducted. It is a task of a manager to develop the plan for the exposure control, to implement and conduct training sessions, and to document the completion of regular training for employees depending on the risk of the occupational exposure to infectious materials.

Provision of the Employee and Patient Safety

One more management issue is the problem of patient and employee safety. Chambers and the group of researchers pay attention to the fact that the employer needs to guarantee the employee and patient safety associated with hazardous waste management and appropriate implementation of work control and infection control practices (Chambers, Mustard, Breslin, Holness, & Nichol, 2013, p. 10). In case of an STI clinic, the needle that caused infection was not placed in the red box for sharp objects, but was wedged on the counter, and it was uncovered (Buchbinder et al., 2013, p. 103). Thus, the situation was potentially risky for the staff.

As a result, it is possible to state that someone among the clinic’s medical staff violated the principles of hazardous waste management creating the risky situation for the safety of both employees and patients. In the research, Wilburn (2004) notes that much attention should be paid to the needle-stick and sharps injury prevention in clinical settings in order to create the safe environments for the personnel. Managers in an STI clinic are responsible for the infection control practices and waste management, the purpose of which is to guarantee the proper handling and disposal of infectious materials in a clinical setting to prevent needle-stick injuries.

The Compensation Issue

The other important problem to be discussed is the issue of compensation for an infected employee and identification of an employer responsible for the incident and treatment costs. It is significant to note that Maria completed all the stages of reporting the incident correctly, while focusing on the immediate informing about the case, filling in the incident report, and making the test (Buchbinder et al., 2013, p. 103).

In this situation, Maria is expected to receive the adequate treatment provided by the employer because she was not vaccinated previously, and the employer did not ensure properly training on the issue (Byrd et al., 2013, p. 500). Thus, Maria should not prove the absence of Hepatitis B before she started to work at the clinic in order to receive the free treatment along with the compensation for non-providing the adequate training on the occupational exposure risks (Mehrdad, Meshki, & Pouryagub, 2013). Furthermore, the probability that Maria was infected previously can be discussed as minimal because of obligatory screenings for the staff in clinics.

Conclusion

In case when the housekeeper is infected with Hepatitis B while performing job duties, the employer should be considered as responsible for providing the free treatment. In case of Maria, BMC is also responsible for compensating the damage for the woman because she was not given the necessary training during the work at BMC or after the transferal, and the employer’s fault caused infection and health harm for Maria. In this situation, it is possible to recommend the employer to focus more on guaranteeing the patient and employee safety and on following the OSHA regulations strictly because of the necessity to train workers on occupational risks, to guarantee the staff safety while controlling waste management, and to provide the support for an injured person if an incident occurs.

References

Buchbinder, S., Shanks, N., & Buchbinder, D. (2013). Cases in health care management. New York, NY: Jones & Bartlett Publishers.

The book is a collection of case studies in the sphere of health care that are organized according to the topic.

Byrd, K., Lu, P., & Murphy, T. (2013). Hepatitis B vaccination coverage among health-care personnel in the United States. Public Health Report, 128(6), 498–509.

The article presents the results of the comparison of Hepatitis B vaccination coverage among the medical personnel in the United States with the Hepatitis B vaccination coverage among the other population in the country.

Chambers, A., Mustard, C., Breslin, C., Holness, L., & Nichol, K. (2013). Evaluating the implementation of health and safety innovations under a regulatory context: A collective case study of Ontario’s safer needle regulation. Implementing Science, 8(1), 9-12.

The authors present the results of the integration of the safer needle regulation in the medical setting in order to contribute to the patient and employee safety in healthcare organizations.

LaMontagne, A., Oakes, M., & Lopez Turley, R. (2004). Long-Term exposure trends in US hospitals: Relationship with OSHA Regulatory and Enforcement Actions. American Journal of Public Health, 94(9), 1614–1619.

The article presents the discussion of exposure trends in the US medical settings in the context of adopting the OSHA regulations.

Mehrdad, R., Meshki, M., & Pouryagub, G. (2013). Effects of training course on occupational exposure to bloodborne pathogens: A controlled interventional study. International Journal of Preventive Medicine, 4(11), 1236-1242.

The authors present the discussion of the results on the role of occupational training on the blood-borne pathogens for the rate of needle stick injuries.

Wilburn, S. (2004). Needlestick and sharps injury prevention. Online Journal of Issues in Nursing, 9(3), 5-15.

The author discusses the approaches of applying the OSHA standards on exposure to blood-borne pathogens to the medical settings.

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