Employee HEalth Surveillance Program

[North Woods Nurse]

Our facility (hospital with outpatient infusion center) is creating an employee health surveillance program to monitor employees at risk for exposure to hazardous drugs. I am having a hard time finding definitions as to which employees should be included in baseline lab work. I have searched the ONS site as well as the OSHA articles.

If your facility has such a program, which employee groups do you include in baseline serum and urine testing? Obviously we will include pharmacy staff and nurses administering chemo. Also considering the risk to lab and radiology personnel, but where do you place laundry and janitorial staff who have a low risk of exposure? And what about Floor nurses who on a rare occasion take care of inpatients who have received chemo in the past 48 hours and may be incontinent? And of course, we need to consider all other departments that are at any level of risk for exposure to body fluids and/or waste.

Thanks for any input.

[North Woods Nurse]

Anyone out there work for a facility that has an employee health surveillance program for staff handling hazardous drugs?? I tried other resources and it seems no one else is doing this yet. IF that's the case, I guess my facility will be ahead of the game when this becomes mandatory.

[DatMurse]

I think you are behind the game to be honest.

Let me google that for you

[Littleguccipiggy]

I didn't reply since you were asking about outpatient surveillance. I currently work inpatient and my workplace follows ONC guidelines. Its done through employee health, so I believe only nurses who hang chemo are monitored.

https://www.ons.org/practice-resources/clinical-practice/healthcare-workers-handling-hazardous-drugs-should-be-monitored

[North Woods Nurse]

Your google link brought me less information than I already have DatMurse. If you can provide information as to what your facility does, I would appreciate it.

[North Woods Nurse]

Thanks LGP, we are a hospital with outpatient services. We do not have a specific employee health program to take care of this, yet. That's what I am working on. I appreciate hearing what your facility does. In all of my posts, calls to other facilities, and research, you are the only one I have found that has such a program.

[greenerpastures]

Please don't think floor nurses/CNAs aren't regularly exposed. I am an oncology floor nurse, we have people every day that are getting chemo, have had chemo in the past week, or are taking oral chemo which is an exposure risk. We have a hospital wide protocol for what to do if a patient can't be admitted to our floor but is going to be admitted anywhere in the hospital that has received/receiving chemo recently. We follow ONS guidelines for decreasing exposures. So please, make sure you include them in your testing as well.

[North Woods Nurse]

Thank you greenerpastures. We are in the process of updating policies for all employees. We do admit in-patients receiving oral chemo and those who have recently had IV chemo. Our OR staff has also done surgery on the occasional chemo patient and our ER staff deals with them. So here lies my concern as I feel other departments should also have baseline and monitoring labs done. Also wondering what the frequency of monitoring lab testing is done at other facilities for all those not specifically dealing with chemo on a weekly basis. I'm just not finding concrete guidelines to finalize this program. One ONS article mentions those mixing and regularly giving chemo should be tested "annually, or every 2-3 years" That does not make it easy to know the best practice. It's easy to say everyone will fill out a yearly health monitoring questionnaire and annual training.

[DatMurse]

Your google link brought me less information than I already have DatMurse. If you can provide information as to what your facility does, I would appreciate it.

General lab work, exposure records. Nothing else. I was just responding to your comment of "being ahead of the game"