Infection Control for New York Health Care Professional ‒ 2024 Update ________________________________
c. Seek expert consultation if viral resistance is sus- pected. d. Administer PEP for 4 weeks if tolerated. Step four: Perform follow-up testing and provide counseling. Consult the website to see further details for this step [27]. New York State Department of Health, Policy Statement and Guidelines to Prevent Transmission of Bloodborne Pathogens from Infected Health Care Personnel through Medical/Dental Procedures Based on evaluation of all available medical and scientific data, the NYSDOH believes the following HIV- and HBV-related policies best safeguard New York’s citizens and protect the viability of our healthcare system [31]: • Preventing HIV and HBV transmission in healthcare settings requires strict adherence to standard barrier precautions and established infection control practices. • Voluntary testing without fear of disclosure or discrimi- nation encourages people at risk for HIV or HBV to seek counseling and testing. • Mandatory screening of New York HCP for bloodborne pathogens is not recommended. • All patients and healthcare workers who have been potentially exposed to bloodborne pathogens should be strongly counseled to seek testing to benefit from medical management. Healthcare workers should seek screening for bloodborne diseases per CDC recommen- dations as part of their healthcare. • Bloodborne pathogen infection alone does not justify limiting a healthcare worker’s professional duties. • After a needle-stick exposure (when the needle has been in an infected patient), a healthcare worker’s risk of infection depends on the pathogen involved, the immune status of the worker, the severity of the needle- stick injury, and the availability and use of appropriate postexposure prophylaxis. • Healthcare workers are not required to inform patients or employers that they have a bloodborne pathogen infection. Such disclosure might serve as a deterrent to workers seeking voluntary testing and medical evaluation.
See Element VII Glossary. Sepsis is a life-threatening condition caused by a host’s extreme response to infection. The Surviving Sepsis Campaign 2021 International Guidelines for Management of Sepsis and Septic Shock 2021 updates define sepsis as life-threatening organ dysfunction caused by a dysregulated host response to infection. Septic shock is a subset of sepsis that manifests with circulatory and cellular/metabolic dysfunction; it is associated with a higher mortality risk [32]. Content Outline I. Sepsis: Scope of the problem A. Sepsis is a life-threatening medical emergency that requires early recognition and intervention. B. Most sepsis cases are community-acquired. C. Seven in 10 patients with sepsis had recently used healthcare services or had chronic conditions requir- ing frequent medical care. D. Sepsis prevalence and mortality in the United States and New York State. Scope: The New York State Education Department November 2022 report entitled New York State Report on Sepsis Care Improve- ment Initiative: Hospital Quality Performance Clinical Center Office of Quality and Patient Safety. The data, obtained in 2019, is the most current published on the scope of sepsis in New York State Education Department [33]. • Severe sepsis and septic shock impact approximately 73,050 adult cases and 624 pediatric cases in NY state in 2019. • On average 30% of adult patients, in 2016, died from this syndrome prior to the implementation of the New York State Sepsis Care Improvement Initiative. In addi- tion, many more may experience lifelong impairments because of the broad impact that sepsis may have on organ and tissue function. • After the initiative the adult mortality rate dropped in 2019 to 23%. • The percentages of in-hospital mortality for pediatric patients fluctuated across quarters; ranging from a low of 6.9% reported in quarter 2, 2016 to a high of 13.2% reported in quarter 4 , 2019. The fluctuation in percentages is likely influenced by the low volume of pediatric cases in each quarter. The number of pediat- ric cases per quarter in 2019 ranged from a low of 151 in Q2 2019 to a high of 159 in Q4 2019.
ELEMENT VII Sepsis Awareness and Education [1].
New York State was the first to initiate a state-level sepsis regu- latory program in 2013 that resulted in a reduction in sepsis mortality. Researchers studied the New York State policies, and other states adapted similar procedures. The sections below are from the NYSDOH syllabus with additional information from the CDC and New York State law [1].
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