Regulatory
Public Policy Platform
AOHP’s 2009-2011 Public Policy
Introduction
The Association of Occupational Health Professionals in Healthcare (AOHP) is a national association whose members represent thousands of health care workers nationwide. The Association is dedicated to promoting the health and safety of workers in healthcare, and strives to influence legislation, regulations and public policy that positively affect occupational health in healthcare.
The Association conducted a member survey in 2008 in an effort to respond to member needs. The survey results identified the following topics as the top public policy issues of concern to AOHP members and were approved by the Executive Board of Directors.
Bloodborne Pathogen Exposure
AOHP advocates for a policy in which individual states remove the current statutory requirement for special written consent for HIV testing to expedite exposure source testing in the case of a blood or body fluid exposure involving a healthcare worker. The Association also continues to advocate for policy that supports a safer environment for employees via the use of safer technology, education, training and prevention regarding sharps injuries. In addition, AOHP is concerned about the underreporting of sharps injuries. AOHP is working on these issues in conjunction with key partners such as, Occupational Safety and Health Administration (OSHA), the National Institute for Occupational Safety and Health (NIOSH) and the Centers for Disease Control and Prevention (CDC).
Fifty-seven healthcare personnel in the United States have been documented as having seroconverted to HIV following occupational exposures. Twenty-six have developed AIDS. There are another 140 with possible, unconfirmed seroconversion.
The timely testing of the source patient for HIV is critical to the evaluation and management of a healthcare worker who has sustained a blood or body fluid exposure. This shortens the time before necessary HIV anti-viral prophylaxis is delivered, eliminates the need for follow up testing, and reduces the level of worker anxiety over the exposure.
Many states currently require special written consent with counseling prior to the ordering of HIV tests on any individual in the healthcare system. The CDC revised its recommendation for HIV testing of adults, adolescents, and pregnant women in healthcare settings in 2006 (Recommendation and Reports, September 22, 2006/55 – RR14).
The CDC advocates that HIV screening should be incorporated into the general consent for medical care after the patient is notified that testing will be performed unless the patient declines or opts out. Separate written consent is no longer recommended.
Safe Patient Handling
AOHP supports efforts to ensure a safer healthcare environment for both the patient and the employee, including utilizing lift/assist devices as the primary method for the prevention of back injuries. For patient transfers, lifts, and repositioning, mechanical equipment must be provided by the facility and used by the caregivers. The Association advocates for regulations, legislation, education, training, research, and prevention activities as related to safer patient handling activities and methodologies. AOHP will work to influence both state and national legislation as it relates to Safe Patient Handling.
Back injuries and other musculoskeletal disorders related to patient handling are the leading cause of workplace disability for nurses and other direct patient care providers. Each year approximately 40,000 nurses report work-related back pain. This represents over three-quarters of a million lost workdays annually due to back injuries among nurses. Many of these injuries are related to manual patient transfer and repositioning tasks.
Nursing aides, orderlies, and attendants had the highest rate of injuries and illnesses with 465 per 10,000 full-time workers (Source: Bureau of Labor Statistics. USDL 08-1716, November 20, 2008). This represents 44,930 days-away-from-work, which is a 12% decrease in the rate compared to 2006. While this information shows improvement, the groups continue to have the highest injury rate.
Respiratory Protection
AOHP supports efforts to ensure a safer workplace for employees by utilizing systems and processes that are evidence-based and supported through research. The Association advocates for increased research, training and education related to respiratory protection from tuberculosis (TB) and other airborne respiratory transmissible diseases. With AOHP and NIOSH’s Memorandum of Understanding, a collaborative relationship has developed with the National Personal Protective Technology Lab (NPPTL) in Pittsburgh, PA where groundbreaking healthcare related research is being conducted on the need for annual fit testing, general respirator use, respirator use in pandemics and other areas related to respirator use in healthcare. AOHP strongly supports NIOSH’s effort to scientifically determine the need for annual fit testing.
Tuberculosis continues to be an ongoing infectious disease issue in the healthcare setting. Diagnosis of the disease is most important in preventing its spread, along with regular screening of healthcare workers. The current ruling from OSHA is that the particulate respirator that is recommended for personal protection against TB is included with the Federal Register for General Industry Respiratory Protection standard. This regulation requires annual fit testing and education for all respirator wearers.
AOHP is dedicated to promoting the health and safety of workers in healthcare. This is accomplished through:
• Advocating for employee health and safety
• Occupational health education and networking opportunities
• Health and safety advancement through best practice and research
• Partnering with employers, regulatory agencies and related associations
For more information please call AOHP headquarters at (800) 362-4347 or e-mail info@aohp.org.
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