Unit 3: Post-Exposure Management

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Course Objectives
  1. Explain the role and timeline of post-exposure prophylaxis (PEP) and follow-up testing protocols for occupational needlestick and sharps exposures.1
  2. Apply infection control and prevention measures to reduce secondary transmission risk in healthcare settings after an exposure.2
  3. Demonstrate effective communication and confidentiality practices in managing exposure events for both patients and employees.3
  4. Evaluate ethical and professional responsibilities for healthcare workers who contract a bloodborne pathogen and continue practicing in clinical settings.
Course Content
Course Creator: Nichelle Volker RMA
Total CE Hours: 1 Credit Hour 
Pace Course #: 586-2619-26

Key Terms: 
  • Baseline Testing
  • Golden Window
  • Post-Exposure Prophylaxis (PEP)
  • Prophylaxis
  • Seroconversion
  • Source Patient

Outline:
  • Introduction
    • Importance of post-exposure management
    •  Assessing workplace risk factors 
      • Transmission rates
      •  Risk by setting
      •  Higher risk devices
    •  Dimension of Exposure 
      • Medical responsibilities
      •  Ethical responsibilities
      •  Communication responsibilities
    •  Knowledge Applied/Scenario: Dimensions applied to sharps injury
  •  Management of Exposure Incident
    • Immediate first aid response
    •  Reporting 
      • Why prompt reporting is so important
    •  The Golden Window
      • Critical timeframes for HIV PEP
      •  Critical timeframes for HBV PEP
      •  No PEP for HCV exposure
    •  Knowledge Applied/Scenario: Steps for preventing secondary exposure
  •  Post-Exposure Prophylaxis and Testing Protocols
    • PEP defined and purpose
    •  Baseline testing 
    • Source patient testing
    •  Required documentation
    •  Privacy and Confidentiality 
    • Standard precautions
    •  Knowledge Applied/Scenario: 2 actions that reduced infection transmission 
  • Communication and Confidentiality
    • HIPAA requirements after an exposure
    •  OSHA standards for employers after an exposure
    •  Communicating exposure to EH and IC
    •  Source Patient testing requests
    •  Post-exposure communication responsibilities
      • EH
      •  IC
      •  Supervisor/manager
      •  Exposure HCW
    •  Source Testing consent 
      • Voluntary
      •  Implied
      • Without
      •  Who can obtain it
      •  Documentation requirements
    •  Documentation requirements after exposure incidents 
      • Employee medical record 
        • Required
        •  Retention
      •  Sharps injury log
        • Required
        •  Prohibited
        •  Retention
        •  Access
      • Knowledge Applied/Scenario: communication errors/violations
  • Return to work protocols and worker responsibilities
    • When infection/transmission actually occurs
      • EH/OM coordination for testing, treatment, and monitoring
      •  Confidentiality
      •  Immediate return to work assessment
      •  Fitness for Duty Evaluation
      •  CDC guidance for + HCW
        • HIV
        •  HBV
        •  HCV
      •  Ongoing Infection Control Precautions
      •  Ethical and Professional Responsibilities
      •  Employee support
  • Best Practices
 
References: 
  1. (2001, June 29). Updated U.S. Public Health Service Guidelines for the Management of Occupational Exposures to HBV, HCV, and HIV and Recommendations for Postexposure Prophylaxis. CDC. Retrieved November 17, 2025, from https://www.cdc.gov/mmwr/preview/mmwrhtml/rr5011a1.htm?
  2.  (n.d.). Bloodborne Infectious Disease Risk Factors. CDC. Retrieved November 17, 2025, from https://www.cdc.gov/niosh/healthcare/risk-factors/bloodborne-infectious-diseases.html?
  3.  (n.d.). Management of Needlestick Injuries in the Health Care Setting. AMA Journal Of Ethics. Retrieved November 17, 2025, from https://journalofethics.ama-assn.org/article/management-needlestick-injuries-health-care-setting/2005-10?
  4. (n.d.). Employer Responsibilities in PEP Management to Prevent HIV Infection Following an Occupational Exposure. New York State Department Of Health. Retrieved November 17, 2025, from https://www.hivguidelines.org/pep-employer-responsibilities/#
  5.   Kinshella, A. L. (2025). The Foundations Of Modern Phlebotomy (1st edition). Intelvio, LLC.
  6.  (n.d.). Incidence and Risks of HIV Infection, Medication Options, and Adverse Effects in Accidental Needle Stick Injuries: A Narrative Review. National Library Of Medicine. Retrieved November 17, 2025, from https://pmc.ncbi.nlm.nih.gov/articles/PMC10831193/
  7.  (n.d.). Electronic Health Record Evolution. Https://Journalofethics.Ama-Assn.org/Home. Retrieved November 17, 2025, from https://pmc.ncbi.nlm.nih.gov/articles/PMC10831193/
  8. (n.d.). Infection Control Basics. CDC. Retrieved November 17, 2025, from www.cdc.gov/infectioncontrol/guidelines/bbp/index.html
  9.  (n.d.). Bloodborne Pathogens and Needlestick Prevention. OSHA. Retrieved November 21, 2025, from https://www.osha.gov/bloodborne-pathogens?
  10.  (2024, December 2). Preventing HIV with PEP. CDC. Retrieved November 21, 2025, from https://www.cdc.gov/hiv/prevention/pep.html?
  11.  (2024, December 2). The Crucial Importance of Taking PEP Within 72 Hours. Phuket Medical Clinic. Retrieved November 21, 2025, from https://pmcclinicphuket.com/the-crucial-importance-of-taking-pep-within-72-hours/
  12.  (n.d.). Public Health Service Guidelines for the Management of Health-Care Worker Exposures to HIV and Recommendations for Postexposure Prophylaxis. CDC. Retrieved November 21, 2025, from https://www.cdc.gov/mmwr/preview/mmwrhtml/00052722.htm#:
  13.  (n.d.). Summary of the HIPAA Privacy Rule. US Department of Health and Human Services. Retrieved November 22, 2025, from https://www.hhs.gov/hipaa/for-professionals/privacy/laws-regulations/index.html
  14.  (n.d.). Occupational Safety and Health Standards. OSHA. Retrieved November 22, 2025, from https://www.osha.gov/laws-regs/regulations/standardnumber/1910/1910.1020
  15. (n.d.). Risk Communication After Health Care Exposures. National Library Of Medicine. Retrieved November 22, 2025, from https://pmc.ncbi.nlm.nih.gov/articles/PMC8451260/#
  16. (2000, July 13). Risk and Management of Blood-Borne Infections in Health Care Workers. National Library Of Medicine. Retrieved November 23, 2025, from https://pmc.ncbi.nlm.nih.gov/articles/PMC88939/
  17.  (2020, October 14). SHEA Updates Guidance for Healthcare Workers with HIV, Hepatitis. SHEA. Retrieved November 23, 2025, from https://shea-online.org/shea-updates-guidance-for-healthcare-workers-with-hiv-hepatitis/?
  18.  (2011, April 5). Double Gloving: Myth Versus Fact. Infection Control Today. Retrieved November 23, 2025, from https://www.infectioncontroltoday.com/view/double-gloving-myth-versus-fact?
  19.  (n.d.). Developing a universal precautions approach to stigma reduction in health care: Insights from clinical and non-clinical health workers. Science Direct. Retrieved November 23, 2025, from https://www.sciencedirect.com/science/article/pii/S2949856225000777?utm
  20.  (n.d.). Infection Control in Healthcare Personnel: Infrastructure and Routine Practices. CDC. Retrieved November 23, 2025, from https://www.cdc.gov/infection-control/hcp/healthcare-personnel-infrastructure-routine-practices/index.html#toc

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