Category: HR-ASSOCHEALTH
POLICY & PROCEDURE
Subject:
Work Restrictions for Health Care Personnel Exposed to or Infected with
Communicable Diseases
Classification:
Management Approved
Policy Owner:
Senior Vice President, Human Resources
Approved by:
WFH President and CEO
Associated Health Medical Director
Effective: March 1, 2009
POLICY:
It is the policy of Wheaton Franciscan Healthcare (WFH) to establish procedures to deal
with situations that arise in the workplace. Work restrictions, as outlined in current Centers
for Disease Control (CDC) guidelines (see attached chart) will be followed when WFH
associates are exposed to or infected with a communicable disease.
RATIONALE:
The objective of this policy is to prevent transmission of infection from health care workers
to patients/residents/clients, and/or to co-workers, and is designed to be in accordance
with WFH’s Mission, Vision and Values:
Value of Respect – Our Value of Respect calls us to ensure that we respect the associate’s
dignity and self worth.
Value of Integrity – Our Value of Integrity requires us to understand and comply with State
and Federal regulations and guidelines in the management and treatment of exposures to
or infection with a communicable disease in health care workers.
Value of Stewardship – Our Value of Stewardship calls for us to maintain health, safety
and security in the workplace, and to minimize lost work time costs and medical expenses
associated with exposure to or infection with communicable diseases.
SCOPE:
This policy applies to all associates and volunteers of WFH owned and managed regions.
PROCEDURE:
A. Associates or volunteers who have a communicable disease, or who have been
exposed to such illness and may be capable of transmitting disease, are required to be
evaluated by an Associate Health & Wellness nurse, or designee.
It is the individual’s responsibility to report known infection with, or unprotected
exposure to, a communicable disease (work-related or non-work related) to the
Associate Health & Wellness Department as soon as possible after the exposure.
If the unprotected exposure is work-related, an Associate Incident Report is to be
completed by the Associate. See Occupational Injury/Illness Policy.
B. When patient/resident infectious disease cultures are detected, an Infection Control
Practitioner will assess the patient situation to determine if significant exposures have
occurred.
C. The Infection Control Practitioner will notify the Associate Health & Wellness
HR-ASSOCHEALTH
Work Restrictions for Health Care Personnel
Exposed to or Infected with Communicable Diseases
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Department if the possibility of staff exposures exists.
D. If post-exposure prophylaxis or testing is recommended by the CDC, the Associate
Health & Wellness nurse, or designee, will contact the Associate Health & Wellness
Medical Director, or physician designee, to obtain orders.
E. If post exposure prophylaxis or testing is indicated, department managers will be
notified by the Associate Health & Wellness nurse of the patient information necessary
to perform contact/exposure investigation for the associates/volunteers within their
department.
F. The manager will contact the appropriate personnel and determine which members of
their staff had unprotected exposure to the infectious patient. The manager will notify
Associate Health & Wellness which health care workers to include in exposure followup.
G. Prescriptions for prophylactic medication will be filled by the nearest Wheaton
Franciscan Healthcare pharmacy (if available), and the invoice/charges for the
medication will be sent to Associate Health & Wellness.
H. When indicated, health care workers will be restricted from work duties for the length of
time recommended by the Centers for Disease Control (see attached chart).
1. When an associate is restricted from work duties because he/she may be
communicable, but does not currently have active disease, he/she will receive
“non-productive” pay from his/her home department for the short term disability
(STD) waiting period, in accordance with plan provisions. After the waiting period,
the associate will receive wage replacement through the STD plan. Use of Paid
Time Off (PTO) bank to supplement STD pay under these circumstances is
optional.
2. If the associate develops active disease, and the source of the infection is nonwork-related, the associate will receive STD benefits in accordance with plan
provisions. (See Short Term Disability Summary Plan Description.)
3. If the associate develops active disease secondary to an unprotected occupational
exposure, the associate will receive worker’s compensation in accordance with
state law. (See Occupational Illness/Injury policy.)
I.
While maintaining associates’/volunteers’ confidentiality, the Associate Health &
Wellness Manager, or designee, will report exposure follow-up activities to the Infection
Control Committee.
Replaces:
Cross reference:
Occupational Injury / Illness policy
Review Period:
Two (2) years
Original Policy Date:
February 1, 2007
Dates Updated:
March 1, 2009
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Work Restrictions for Health Care Personnel
Exposed to or Infected with Communicable Diseases
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Summary of suggested work restrictions for health care personnel exposed to or infected with
infectious diseases of importance in health care settings, in the absence of state and local regulations
Modified from American Committee on Immunization Practices (ACIP) recommendations
Disease/problem
Work restriction
Duration
Conjunctivitis (e.g., “pink eye”)
Restrict from patient contact
and contact with the patient’s
environment
Until discharge ceases
Cytomegalovirus infections
No restriction
Category
II
II
Diarrheal diseases
Acute stage (diarrhea with
other symptoms)
Restrict from patient contact,
contact with the patient’s
environment, or food handling
Until symptoms resolve
Convalescent stage,
Salmonella spp.
Restrict from care of high-risk
patients
Until symptoms resolve;
consult with local and state
health authorities regarding
need for negative stool
cultures
IB
Diphtheria
Exclude from duty
Until antimicrobial therapy
completed and 2 cultures
obtained  24 hours apart are
negative
IB
Enteroviral infections
Restrict from care of infants,
neonates, and
immunocompromised patients
and their environments
Until symptoms resolve
II
Hepatitis A
Restrict from patient contact,
contact with patient’s
environment, and food
handling
Until 7 days after onset of
jaundice
IB
IB
Hepatitis B
Personnel with acute or
chronic hepatitis B surface
antigemia who do not
perform exposure-prone
procedures
No restriction*; refer to state
regulations; standard
precautions should always be
observed
Personnel with acute or
chronic hepatitis B e
antigenemia who perform
exposure-prone
procedures
Do not perform exposureprone invasive procedures
until counsel from an expert
review panel has been sought;
panel should review and
recommend procedures the
worker can perform, taking into
account specific procedures as
well as skill and technique of
worker; refer to state
regulations
Hepatitis C
No recommendation
II
Until hepatitis B e antigen is
negative
II
Unresolved
issue
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Exposed to or Infected with Communicable Diseases
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Disease/problem
Work restriction
Duration
Category
Herpes simplex
Genital
No restriction
Hands (herpetic whitlow)
Restrict from patient contact
and contact with the patient’s
environment
Orofacial
Evaluate for need to restrict
from care of high-risk patients
II
Do not perform exposureprone invasive procedures
until counsel from an expert
review panel has been sought;
panel should review and
recommend procedures the
worker can perform, taking into
account specific procedure as
well as skill and technique of
the worker; standard
precautions should always be
observed; refer to state
regulations
II
Human immunodeficiency
virus
II
Until lesions heal
IA
Measles
Active
Exclude from duty
Until 7 days after the rash
appears
IA
Postexposure
(susceptible personnel)
Exclude from duty
From 5th day after 1st
exposure through 21st day
after last exposure and/or 4
days after rash appears
IB
Exclude from duty
Until 24 hours after start of
effective therapy
IA
Active
Exclude from duty
Until 9 days after onset of
parotitis
IB
Postexposure
(susceptible personnel)
Exclude from duty
From 12th day after 1st
exposure through 26th day
after last exposure or until 9
days after onset of parotitis
II
Meningococcal infections
(N. meningitidis)
Mumps
Parvo virus (B19)
No restriction
Pediculosis (“Lice”)
Restrict from patient contact
Until treated and observed to
be free of adult and immature
lice
IB
Exclude from duty
From beginning of catarrhal
stage through 3rd week after
onset of paroxysms or until 5
days after start of effective
antimicrobial therapy
IB
Pertussis (“Whooping Cough”)
Active
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Exposed to or Infected with Communicable Diseases
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Disease/problem
Work restriction
Duration
Category
Postexposure
(asymptomatic personnel)
No restriction, prophylaxis
recommended
II
Postexposure
(symptomatic personnel)
Exclude from duty
Until 5 days after start of
effective antimicrobial therapy
IB
Active
Exclude from duty
Until 5 days after rash appears
IA
Postexposure
(susceptible personnel)
Exclude from duty
From 7th day after 1st
exposure through 21st day
after last exposure
IB
Restrict from patient contact
Until cleared by medical
evaluation
Active, draining skin
lesions
Restrict from contact with
patients and patient’s
environment or food handling
Until lesions have resolved
Carrier state
No restriction, unless
personnel are
epidemiologically linked to
transmission of the organism
Rubella (“German Measles”)
Scabies
Staphylococcus aureus
infection
Streptococcal infection, group
A
IB
IB
Restrict from patient care,
contact with patient’s
environment, or food handling
Until 24 hours after adequate
treatment started
IB
Active disease
Exclude from duty
Until proved noninfectious
IA
PPD converter
No restriction
Tuberculosis
IA
Varicella (“Chicken Pox”)
Active
Exclude from duty
Until all lesions dry and crust
IA
Postexposure
(susceptible personnel)
Exclude from duty
From 10th day after 1st
exposure through 21st day
(28th day if VZIG given) after
last exposure
IA
Localized, in healthy
person
Cover lesions; restrict from
care of high-risk patients†
Until all lesions dry and crust
II
Generalized or localized in
immunosuppressed
person
Restrict from patient contact
Until all lesions dry and crust
IB
Postexposure
(susceptible personnel)
Restrict from patient contact
From 10th day after 1st
exposure through 21st day
(28th day if VZIG given) after
last exposure or, if varicella
occurs, until all lesions dry and
crust
IA
Zoster (“Shingles”)
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Exposed to or Infected with Communicable Diseases
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Disease/problem
Work restriction
Duration
Viral respiratory infections,
acute febrile
Consider excluding from the
care of high risk patients‡ or
contact with their environment
during community outbreak of
RSV and influenza
Until acute symptoms resolve
Category
IB
*Unless epidemiologically linked to transmission of infection.
†Those susceptible to varicella and who are at increased risk of complications of varicella, such as neonates and
immunocompromised person of any age.
‡High-risk patients as defined by the ACIP for complications of influenza.
Category IA
Strongly recommended for all hospitals and strongly
supported by well-designed experimental or
epidemiologic studies.
Category IB
Strongly recommended for all hospitals and reviewed
as effective by experts in the field and a consensus of
Hospital Infection Control Practices Advisory
Committee members on the basis of strong rationale
and suggestive evidence, even though definitive
scientific studies have not been done.
Category II
Suggested for implementation in many hospitals.
Recommendations may be supported by suggestive
clinical or epidemiologic studies, a strong theoretic
rationale, or definitive studies applicable to some but
not all hospitals.
No recommendation; unresolved issue
Practices for which insufficient evidence or consensus
regarding efficacy exists.
Source: Centers for Disease Control, The Hospital Infection Control Practices Advisory Committee (1998, June).
Recommendations for the prevention of infections in health care personnel. American Journal of Infection
Control, 26. 289-354.

See “Guidelines for Health Care Workers Who Are Immunosuppressed and/or Infected with Bloodborne
Pathogens” policy and procedure.
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Exposed to or Infected with Communicable Diseases
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