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Record W2981620124 · doi:10.1093/ofid/ofz360.1071

1208. Preventing Transmission of Bloodborne Viruses from-Infected Healthcare Workers to Patients in Canadian Healthcare Settings: A National Guideline

2019· article· en· W2981620124 on OpenAlexaffabout
Toju Ogunremi, Katherine Defalco, Bree Johnston, Isabelle Boucoiran, Maureen Cividino, Blaine Cleghorn, Melody Ann Isinger, A. Mark Joffe, Tony Mazzulli, Yves Robert, Mary Vearncombe, David Wong, Jason Wong, Kathy Dunn, Bonnie Henry

Bibliographic record

VenueOpen Forum Infectious Diseases · 2019
Typearticle
Languageen
FieldMedicine
TopicHepatitis B Virus Studies
Canadian institutionsMinistry of HealthBC Centre for Disease ControlSunnybrook Health Science CentreUniversity Health NetworkHealth Sciences CentreMount Sinai HospitalUniversity of AlbertaSt. Joseph’s Healthcare HamiltonToronto General HospitalDalhousie UniversityCentre Hospitalier Universitaire Sainte-JustinePublic Health Agency of Canada
Fundersnot available
KeywordsMedicineTransmission (telecommunications)Infection controlGuidelineHealth careViral loadHepatitis B virusPersonal protective equipmentPost-exposure prophylaxisEnvironmental healthIntensive care medicineHuman immunodeficiency virus (HIV)VirologyVirusInternal medicinePathologyInfectious disease (medical specialty)DiseaseCoronavirus disease 2019 (COVID-19)

Abstract

fetched live from OpenAlex

Abstract Background Infectious agents, such as bloodborne viruses (BBVs), can potentially be transmitted from healthcare workers (HCWs) to patients. In an effort to reduce this risk to patients, this guideline, which provides a framework for policies on the management of HCWs infected with BBVs in Canada, was developed. Methods A total of six systematic reviews (1995–2016) were conducted to inform the risk of transmission of human immunodeficiency virus (HIV), hepatitis C virus (HCV), and hepatitis B virus (HBV) from infected HCWs to patients and the infectivity of each virus related to source serum viral load. Three environmental scans were conducted to inform sections on disclosure of HCW’s serologic status, Expert Review Panels, and lookback investigations. Government partners and key stakeholder organizations were consulted and a Task Group provided technical expertise. Results The risk of HCW-to-patient BBV transmission is negligible, except during exposure-prone procedures where there is a risk of HCW injury and possible exposure of a patient’s open tissues to the HCW’s blood. Transmission rates were lowest with HIV and highest with HBV (Table 1). Rates varied with several factors including source viral load, nature of potential exposure, infection prevention and control breaches, susceptibility of exposed patient, and use of post-exposure prophylaxis where relevant. The extent of reporting bias for exposure incidents where transmission did not occur is unknown. Current antiviral therapy informed guideline recommendations, with viral load thresholds provided to assist treating physician, Expert Review Panels and regulatory authorities in determining a HCW’s fitness for practice. Conclusion Routine Practices (or Standard Precautions) are critical to prevent HCW-to-patient transmission of infections; including BBVs. Recommendations provided in this guideline aim to further reduce the already minimal risk of HCW-to-patient transmission. The guideline provides a pan-Canadian approach for managing HCWs infected with a BBV, with recommendations directly impacting clinical practice related to preventing and controlling healthcare-associated infections. Disclosures All authors: No reported disclosures.

Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.

How this classification was reachedexpand

Full frame distilled prediction

Teacher imitation

Not calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.

metaresearch head score (Codex)0.000
metaresearch head score (Gemma)0.001
Version: codex-gemma-dda1882f352aValidation status: machine_predicted_unvalidated
Candidate categoriesMeta-epidemiology (narrow)
Consensus categoriesnone
DomainCandidate signal: none · Consensus signal: none
Study designCandidate signal: Observational · Consensus signal: Observational
GenreCandidate signal: Empirical · Consensus signal: Empirical
Teacher disagreement score0.022
Threshold uncertainty score1.000

Codex and Gemma teacher scores by category

CategoryCodexGemma
Metaresearch0.0000.001
Meta-epidemiology (narrow)0.0000.000
Meta-epidemiology (broad)0.0010.000
Bibliometrics0.0000.001
Science and technology studies0.0000.000
Scholarly communication0.0000.000
Open science0.0000.000
Research integrity0.0000.000
Insufficient payload (model declined to judge)0.0000.000

Machine scores (provisional)

The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.

Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.

Opus teacher head0.016
GPT teacher head0.320
Teacher spread0.305 · how far apart the two teachers sit on this one work
Validation statusscore_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it

Classification

machine, unvalidated

Machine predicted; a candidate call from one teacher head, not a consensus.

Study designObservational
Domainnot available
GenreEmpirical

How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".

Quick stats

Citations2
Published2019
Admission routes2
Has abstractyes

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