Personal Health & Compliance
To safely work in the clinic long-term, every staff member must maintain their own occupational health record and participate in the clinic's infection control governance.
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A. Hepatitis B Immunization
Who Must Be Vaccinated
All healthcare workers exposed to blood and body fluids.
Schedule
| Dose | Timing |
|---|---|
| 1st | Baseline (pre-placement) |
| 2nd | 1 month after 1st |
| 3rd | 6 months after 1st |
Post-Vaccination Titers
- Test anti-HBs 1–2 months after completing the 3rd dose.
>=10 mIU/mL = immune. Document and file.<10 mIU/mL = non-responder. Repeat series or receive HBIG after any exposure. [1]
If you do not seroconvert after two complete vaccine series, you are classified as a non-responder. You must receive HBIG after any blood exposure regardless of the source patient's status.
B. Tuberculosis Screening
Who Must Be Screened
Staff who handle TB patients or work in environments where TB transmission is possible.
Schedule
| Timing | Tests |
|---|---|
| Pre-placement | Mantoux test + chest X-ray |
| Periodic (every 1–2 years) | Mantoux test or IGRA + symptom review |
| Pre-retirement | Chest X-ray + symptom review |
If Mantoux Converts
A new positive Mantoux (>=10 mm induration, or >=5 mm if immunocompromised) requires:
- Chest X-ray to rule out active TB
- Referral to the district TB clinic for latent TB evaluation
- Work restriction until active TB is excluded
C. Other Recommended Vaccinations
| Vaccine | Schedule | Notes |
|---|---|---|
| Influenza | Annual | Recommended for all patient-facing staff |
| MMR | 2 doses if non-immune | Especially for staff born after 1967 with no documented immunity |
| Varicella | 2 doses if no history of chickenpox | Critical for staff working with immunocompromised patients |
| Tdap | 1 dose, then Td every 10 years | Replace one Td dose with Tdap |
D. Sharps Injury Surveillance (SIS)
Your Responsibility
- Report every needlestick, sharps injury, and mucosal splash.
- Do not downplay minor injuries — even shallow scratches can transmit blood-borne pathogens.
- Ensure your supervisor files OHU/SIS-1 and SIS-2 within 24 hours.
- Attend all scheduled follow-up appointments after an exposure. [1]
E. Link Nurse & Internal Audits
Link Nurse Role
Each clinic appoints a Link Nurse specifically trained in infection control. They:
- Conduct internal audits (hand hygiene compliance, bin dating, PPE availability)
- Act as the liaison between clinic administration and staff
- Oversee infection control training and competency updates
- Report findings to the clinic-level Infection Control Committee
What Auditors Check
| Checkpoint | Frequency | Standard |
|---|---|---|
| Hand hygiene technique | Monthly | WHO 5 Moments observed |
| Sharps bin dating / fill level | Weekly | Dated, <=3/4 full, sealed on time |
| Spillage kit completeness | Weekly | All items present and in-date |
| PPE stock levels | Weekly | No stock-outs of gloves, masks, aprons |
| Environmental cleaning quality | Monthly | Colour-coded mop compliance, terminal cleaning logs |
External Audits
The State Health Department conducts external audits twice a year. Findings are reported to the District Health Office and clinic management. Corrective action plans must be submitted within the stipulated timeframe.
F. Staff Responsibilities Summary
- Hepatitis B vaccination series completed and titers documented
- TB screening up to date (Mantoux + CXR)
- Annual influenza vaccination (recommended)
- SIS training completed
- Attend Link Nurse training when nominated
- Participate in internal audits without obstruction
- Maintain personal health record accessible to Occupational Health Unit
A staff member with undiagnosed TB or non-immune Hepatitis B status is a risk to both themselves and the patients they serve. Keeping your own health record current is not bureaucracy — it is clinical duty.