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1. What happens after I first report to CARNA that I am positive for a blood-borne virus infection (BBVI)?
If you answered "yes" to the BBVI question, this information will be forwarded to the medical officer of health, as required by Alberta health professions legislations. You will be contacted by the registrar or deputy registrar to discuss your practice setting and exposure-prone procedures (EPP). CARNA will not be collecting information on specific diagnosis
2. Do I need to tell my employer or occupational health and safety personnel that I am positive for a BBVI?
No. You are not routinely required to inform your employer of your BBVI. You would however, have a professional responsibility to tell your employer if your practices required modification because of the BBVI. This information should be directed to your employer’s occupational health and safety personnel (if available), otherwise to the person/area designated in your workplace to receive workplace restrictions. The deputy registrar will discuss employer notification with you if practice modifications are recommended.
3. Do I need to inform patients/clients in my care that I am infected with a BBVI?
No. Because of the low risk of transmission, CARNA members are not required to inform their patients of their BBVI.
4. Will CARNA share the information about member BBVI with anyone else?
CARNA will notify the local medical officer of health as required by Alberta health professions legislation. No one else will receive information about BBVI without your prior consent.
5. Will CARNA ask for my medical records pertaining to the BBVI?
No. CARNA will not require your medical records. In some instances, the medical officer of health (or designate) conducting public health follow up may require specific information regarding your BBVI.
6. What additional information will CARNA request and discuss after I have reported BBVI?
Members who engage in EPP will be informed of any practice recommendations by the Alberta Expert Review Panel on Blood-Borne Infection in Health-Care Workers. The member will be asked by CARNA to sign an agreement for practice modifications.
7. What types of procedures are considered exposure-prone procedures and non-exposure prone procedures?
- Exposure-Prone Procedures
Assistance with open general surgery, emergency trauma care when there is risk of injury from sharp objects such as fractured bones and rectal examination in the presence of suspected pelvic fractures
- Non-Exposure Prone Procedures
Routine oral or vaginal examinations, IV starts, elective peripheral phlebotomy, routine physical examinations and minor suturing
Adapted from: The College of Physicians and Surgeons of British Columbia, Blood-Borne Communicable Diseases in Physicians.
8. Am I required to report my BBVI status every year at the time of licensure renewal?
Yes. You will be required to report your BBVI status every year at the time of renewing the practice permit. The medical officer of health notification of member BBVI occurs only once, unless a subsequent BBVI is reported.
9. Am I required to notify CARNA when I change my employer, work setting, or nursing practices?
Yes. You are required to notify the CARNA deputy registrar at 780.453.0537 or 1.800.252.9392, ext. 537 if you change your employer, your work setting or nursing practices. A change in nursing practices involves a change in the type of care provided to individuals, e.g. post-surgical care or labor and delivery.
10. What can I expect after the medical officer of health is notified of my BBVI by CARNA?
You will be contacted by the medical officer of health, or a designate, regarding your BBVI if you were not contacted previously. In Alberta, designates for the medical officer of health often are public health nurses with communicable disease expertise. You will receive standard public health followup to optimize public health protection, including an assessment of any work practices that potentially pose a risk to individuals receiving care. You will be provided with individual guidance and support to promote your health and the health of those close to you (e.g. family or other contacts).
11. Will I be referred for assessment to the Alberta Expert Review Panel for Blood-Borne Virus Infection in Health-Care Workers?
CARNA members involved in exposure-prone procedures would likely be referred to the expert review panel. The decision for referral to the expert review panel is most often made by the medical officer of health or the attending physician. The medical officer of health or attending physician will discuss the referral with you.
12. What does the expert review panel do when a health-care worker is referred for assessment?
The referral occurs for risk assessment of members who practice exposure-prone procedures. The expert review panel will counsel health-care workers on an individual and confidential basis concerning continued and modified practice and possible therapy that may alter infectivity. The expert review panel considers the health status of health-care workers in addition to other factors such as the service provided and adherence to infection prevention and control practices. The health-care worker and his/her regulatory body receive a copy of the expert review panel’s recommendations.
13. What is the risk of transmitting BBVI to patients or clients under my care?
The risk of transmission to the patient/client following exposure is dependent on several factors including the status of infectivity (e.g. viral load) of the CARNA member’s blood, the size of the inoculum (the volume of the blood/infectious body fluid exposure), the type of exposure (e.g. internal tissue exposure creates greater risk rather than exposure to mucous membrane) and the susceptibility of the host (the patient/client) to BBVI. In general terms, hepatitis B is most easily transmitted followed by hepatitis C and after that HIV.
14. What do I need to do if there is an incident where there is a bleedback of my blood onto a patient's open tissues? (An example of a bleedback could involve a needlestick injury to your finger through gloved hands when blood from your injured finger touches the open tissue of the patient).
You are required to immediately report all exposure incidents (whether you are the source or the recipient of the exposure) to a qualified health professional for risk assessment, e.g. occupational health and safety staff, infection control professional, and/or the local medical officer of health. Immediate reporting after a blood/body fluid exposure incident is very important as the success of treatment is time sensitive. You should become informed about employer procedures for reporting exposure incidents involving blood or specific body fluids.
15. What should I do if I have an open wound or my skin is otherwise not intact and I am providing direct care to patients?
You should contact a qualified health professional for advice (e.g. infection control professional, occupational health and safety professional, or the local medical officer of health). Usually it is recommended that gloves are worn when providing hands-on care and in some instances double gloving is recommended.
16. Is there a CARNA staff member phone number that I can call to ask additional questions?
Yes. You can contact the deputy registrar by telephone at 780.453.0537 or 1.800.252.9352, ext. 537.
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