Hepatitis B Core antibody policy

[WINDYCITYRN]

Question for my fellow HD RNs out there. What is the policy where you work with regards to patients with Hepatitis B Core Antibodies that are Reactive. With hep b Antigen positive patients, we bleach as well as isolate. But I have run into pts where the hep b core antibodies are reactive (but negative B antigens) and we use the hep b machine and isolate as well.

2nd question: Do you bleach your hepatitis B machine after a hep b antigen reactive patient? We do , but I have heard someone say it is not necessary to bleach the Hep B machine (because it is only used for hep B pts)..

[AcuteHD]

At our clinic (not one of the big 2) if antibodies are reactive we check the surface antigen monthly, if antigen is negative then they dialyze in general population with standard disinfection. If antibodies are non-reactive then we only check annualy. We don't have a dedicated Hep B machine, so we always bleach after a hep b pt.

IMHO: If you are running antigen(-) pts on the same machine as antigen(+) pts then you need to bleach. If you only run (+) pts and there is ABSOLUTLY no chance of running a (-) pt on that machine then, maybe, you wouldn't have to bleach, but why risk it?

[WINDYCITYRN]

Thanks for the reply .. A hepb neg ant (+core ab) running on a dedicated hep b machine raises questions for me even if we have MD order to use b machine...