Presentation to Needlestick Injuries Conference

1. Presentation to Needlestick Injuries Conference 1. Transmission of blood borne pathogens. An increasing problem since early 1990s. 2. Health care workers undertaking exposure prone procedures at risk, also lesser risk to patients  3. Advisory Group established in 1995 to advise Minister. Report issued in 1997, which resulted in putting in place of Standing Advisory Committee.

2. Presentation to Needlestick Injuries Conference 4. Standing Committee produced report “The Prevention of Transmission of Blood-Borne Diseases in the Health Care Setting 2006”.   The Department of Health and Children requested the HSE to drive forward the implementation of the Report. 5. On staffing related matters, the HSE established a team to initiate discussions with relevant staff bodies with a view to getting their buy in and co-operation with the staff related recommendations in the Report. 6. Staff representative organisations involved are IMO, INO, IHCA, IDA

3. Presentation to Needlestick Injuries Conference 7. Seek to ensure there is a co-ordinated approach to the prevention,identification, and treatment of blood borne diseases and are designed to support those members of the health care team at risk of exposure to blood borne pathogens, including doctors, nurses / midwives and dentists. 8. Applies to staff involved in EPPs, small fraction of the total population of HCWs “EPPs are those invasive procedures where there is a risk that injury to the worker may result in the exposure of the patients open tissues to the blood of the worker.”

4. Work Categories Staff divided into three different categories: Category 1 Staff performing EPPs Category 1a Staff may be excluded from practice if infected with BBV because EPPs form an integral part of their work Category 1b Staff will be asked to restrict certain aspects of their work that involve EPPs, but can continue in their profession.

5. Work Categories contd…/ Category 2 Staff who may be at risk of inoculation injuries but do not undertake EPPs Category 3 Staff working in administration who are not exposed to blood or body fluids

6. Reasonable Accommodation • Recognition that staff who may be infected by a BBV are entitled to reasonable accommodation by their employer. • Staff required to fully co-operate with treatment programme, Modification of working procedures, or retraining as deemed necessary. • Main focus is to maintain individual in employment, in their own post, albeit with certain restrictions to normal range of duties in particular circumstances. • Where this is not possible, the emphasis will be on redeployment and retraining in a related field of expertise, where necessary of affected staff.

7. Redeployment • Where redeployment is necessary, every effort to re-deploy within the same organisation. Where this involves change in job description / clinical practice, this must be agreed with HCW. Issues of dispute to be dealt with by National Advisory Panel.

8. Retraining • HCW in early stages of career. Consultation with Training Bodies. Ring fenced positions. Retention of salary and other conditions of employment. • NAP key role

9. Vocational Rehabilitation • Restriction on performing EPPs is a medical, not a functional restriction. • Emphasis on keeping person at work, rather than on sick leave. • Optimisation of skills and experience.

10. Treatment Costs • Treatment costs i.e. GP, Casualty, Consultant, prescription charges borne by employer. Must be obtained in public health service.

11. National Advisory Panel • 3 nominees from employer and 3 nominees from staff side • Independent Chair – Ms Evelyn Owens (retired Chairperson Labour Court and former Senator). • The panel will operate in circumstances where local efforts have been unsuccessful in facilitating the location or relocation of individuals for training and employment purposes.

12. Payment to Affected Staff Following confirmation of initial screening and diagnosis of Hep B, Hep C or HIV and given medical evidence that the staff member needs to curtail clinical practice and is consequently unable to work, the following pay arrangements will apply to such staff: 1. Full pay, inclusive of premium and allowances for six months 2. Does not interfere with normal sick leave entitlements 3. Subject to full co-operation

13. Special Extensions First Special Extension If unable to return to work after six months, a first special extension may be granted. Must be approved by Asst. National Director of HR. Same pay arrangements will continue for a further period of three months. Second Special Extension If medical evidence indicates that further absence from work is necessary, and reasonable expectation of the individuals return to work, a further final extension for an additional three months. Basic pay only for this three months.