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Management of healthcare workers living with a blood borne virus

Supporting Documents

Overview of the guidelines and key recommendations

The new guidelines allow healthcare workers living with a blood borne virus to perform exposure prone procedures, provided they comply with the guidelines.

  • All workers have a professional and ethical responsibility to take reasonable steps to know their blood borne virus status
  • All workers should consider undertaking regular testing for blood borne viruses
  • All workers should be vaccinated against hepatitis B virus
  • All workers have the right to access confidential testing, counselling and treatment
  • Workers who undertake exposure prone procedures must take reasonable steps to know their blood borne virus status and are to undergo testing at least once every three years. They may be required to confirm that they comply with the national guidelines, if requested by the relevant Australian Health Practitioner Regulation Agency board.

BBV testing requirements for HCWs who perform EPPs (CDNA 2018)

Tests positive for HBV

  1. Stops performing EPPs immediately
  2. If under care of specialist and viral load <200IU/mL
  3. Resume EPPs (re-tested every 6 months if on treatment, 3 months if not on treatment)

Tests positive for HCV

  1. Stops performing EPPs immediately
  2. If under care of specialist, HCV negative (if not related) or SVR (if treated)
  3. Resume EPPs (re-tested for BBVs according to guidelines)

Tests positive for HIV

  1. Stops performing EPPs immediately
  2. If under care of specialist, on effective cART and viral load <200 copies/mL (or elite controller)
  3. Resume EPPs (re-tested every 3 months)

Tests negative for BBVs

  1. Continues to perform EPPs
  2. Re-tested for BBVs according to guidelines

Department of Health Expert Advisory Committee

Routine management of workers who perform exposure prone procedures is outlined in the national guidelines.

An Expert Advisory Committee (the Committee) has been established to:

  • provide expert advice where there is a complex situation or a dispute over the ability of a worker living with a blood borne virus to continue with all or part of their duties. The worker must not perform exposure prone procedures pending advice of the Committee, but is able to perform duties that do not include exposure prone procedures and practice within the infection control requirements of the Australian Guidelines for the Prevention and Control of Infection in Healthcare.
  • undertake an investigation or conduct a lookback exercise.

Referral to the Committee

Referral to the Committee should only be made after consultation with the guideline. Please use the referral checklist to help determine if the referral is appropriate.

Who may consult the Committee?

  • A designated representative of the employer of the infected worker.
  • The treating doctor of the infected worker or student.

In what circumstances?

Initial clearance for individual healthcare workers who have been previously excluded from work involving exposure prone procedures is the responsibility of the treating doctor. However, with more complex situations, the treating doctor may choose to consult with the Communicable Diseases Branch of the Department of Health, who may then also refer the request onto the Committee.

An example of a complex situation may include where other considerations apart from virological response are present and further advice may be required. These additional considerations include recency of practice, evidence of behaviour which could have affected the workers standard of practice, individual work variances etc.

How to refer to the Expert Advisory Committee

To make a referral to the Committee email, or phone 07 3328 9754 during business hours, Monday to Friday.

If the conduct of the healthcare worker places others or the public at risk, obligations related to notifying the Office of the Health Ombudsman or the Australian Health Practitioner Regulation Authority must be considered and is the responsibility of the referrer.

Last updated: 30 April 2019