Management of healthcare workers after
occupational exposure to hepatitis C virus
We believe that our
proposed post-needlestick injury HCV investigation protocol provides a
practical approach for assessing injured healthcare workers in the current
therapeutic and legal contexts of HCV management in Australia. We encourage
the development and acceptance of a common protocol for use in all
1: Blood and body fluid exposures among
healthcare workers at major metropolitan hospitals in Victoria
Months of assessment
Blood and body-fluid
Total (% of all
* Patient was
positive for antibodies to hepatitis C virus. † 60%–85% were
2: Proposed management plan to reduce
needlestick injuries and their risk among healthcare workers
1. Reduction in the
risk of needlestick injuries and other exposures through:
education of healthcare workers about phlebotomy and intravenous cannula
insertion, with credentialling of knowledge and performance.
Availability of suitable sharps-disposal containers
Introduction of safety cannulas
Rationalisation/avoidance of unnecessary procedures
Appropriate healthcare worker workload and adequate staff–patient ratios
(excessive tiredness and work-related stress are clearly associated with
higher rates of needlestick injury).
2. Appropriate health
management and follow-up systems for staff, including appropriate
counselling about hepatitis B and C virus and HIV infection.
vaccination program for healthcare workers, especially hepatitis B
vaccination, to prevent bloodborne diseases.
3: Proposed protocol for follow-up of
healthcare workers after needlestick injury involving a patient with
hepatitis C virus infection
Many of the proposals in
this protocol are the result of a meeting of clinicians held in Melbourne,
Victoria, in 2001 to discuss a standardised approach to nosocomial HCV
transmission. We acknowledge the input of these clincians and also the
assistance of the infection control practitioners who helped obtain data: Ms
Rhea Martin (Austin and Repatriation Medical Centre), Ms Fiona Wilson
(Western General Hospital), Ms Joanne Cocks (St Vincent’s Hospital), Mr
Richard Bartolo (Mercy Hospital), Associate Professor Denis Spelman (Alfred
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(Received 31 Mar 2003,
accepted 2 Jun 2003)
Department of Infectious Diseases, Austin and Repatriation Medical Centre,
MD, FRACP, FAFPHM,
Director, and Professor, Department of Medicine, University of Melbourne,
and Department of Epidemiology and Preventive Medicine, Monash University,
Department of Gastroenterology, Austin and Repatriation Medical Centre,
Director of Gastroenterology and Hepatology, and Professor of Medicine,
Department of Medicine, University of Melbourne, Parkville, VIC.
Victorian Infectious Diseases Service, Royal Melbourne Hospital,
Infectious Diseases Physician.
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