Occupational Health information for our employees.
All licensed and unlicensed healthcare professionals (“HCPs”) involved in direct patient care responsibilities are required to show proof of successful completion of a Basic Life support Program.
Premier Medical Staffing Services only accepts BLS Certifications that have an in-person return demonstration component.
Milwaukee/Madison/Green Bay/Fox Valley/Wausau/Eau Claire/Northern Illinois
American Heart Association
Premier Medical Staffing Services has set up accounts to offer discounted healthcare services to our employees. Please contact your HR representative (Rachel Osswald or Joanna Hargraves 800-439-7012) to set up an appointment with an Occupational Health Clinic near you.
Most occupational health facilities will perform Immunizations, Employment Physicals, TB tests, and drug screens.
Primary physician can fax Immunization record to 800-882-0886.
All HCPs, at time of hire, will provide a Statement of Satisfactory Health indicating that he or she is free of communicable disease and is capable of performing the tasks required of his or her position. A Physician, Nurse Practitioner, or Physician Assistant may complete the Statement of Satisfactory Health. Equivalent documentation provided by the health practitioner will be accepted.
A Statement of Satisfactory Health is required annually for all healthcare professionals with direct patient contact.
Upon hire, all HCPs must provide evidence that they are free from active tuberculosis, prior to their first assignment and at least annually thereafter.
Healthcare professionals must provide a statement completed within the past twelve (12) months that the PPD test was administered, showing the date of administration, date the test was read and the results. A photocopy of the statement will be accepted.
Tuberculin Skin Testing Information from the Centers for Disease Control and Prevention (CDC)
What is Tuberculin Skin Testing?
Answer: The Mantoux tuberculin skin test (TB Test) is the standard method of determining whether a person is infected with Mycobacterium tuberculosis. Reliable administration and reading of the TB Test requires standardization of procedures, training, supervision, and practice.
How is the TB Test Administered?
Answer: The TB Test is performed by injecting 0.1 ml of tuberculin purified protein derivative (PPD) into the inner surface of the forearm. The injection should be made with a tuberculin syringe, with the needle bevel facing upward. The TB Test is an intradermal injection. When placed correctly, the injection should produce a pale elevation of the skin (a wheal) 6 to 10 mm in diameter.
How is the TB Test Read?
Answer: The skin test reaction should be read between 48 and 72 hours after administration. A patient who does not return within 72 hours will need to be rescheduled for another skin test. The reaction should be measured in millimeters of the induration (palpable, raised, hardened area or swelling). The reader should not measure erythema (redness). The diameter of the indurated area should be measured across the forearm (perpendicular to the long axis).
How Are TB Test Reactions Interpreted?
Answer: Skin test interpretation depends on two factors:
- Measurement in millimeters of the induration
- Person’s risk of being infected with TB and of progression to disease if infected
Classification of the Tuberculin Skin Test Reaction
Induration of 5 or more millimeters is considered positive in…
- HIV-infected persons
- A recent contact of a person with TB disease
- Persons with fibrotic changes on chest radiograph consistent with prior TB
- Patients with organ transplants
- Persons who are immunosuppressed for other reasons (e.g., taking the equivalent of >15 mg/day of prednisone for 1 month or longer, taking TNF-a antagonists)
Induration of 10 or more millimeters is considered positive in…
- Recent immigrants (< 5 years) from high-prevalence countries
- Injection drug users
- Residents and employees of high-risk congregate settings
- Mycobacteriology laboratory personnel
- Persons with clinical conditions that place them at high risk
- Children < 4 years of age
- Infants, children, and adolescents exposed to adults in high-risk categories
An induration of 15 or more millimeters is considered positive in any person, including persons with no known risk factors for TB. However, targeted skin testing programs should only be conducted among high-risk groups.
QuantiFeron Gold TB Testing Information from the Centers for Disease Control and Prevention (CDC)
What is the QuantiFERON Gold test?
Answer: QuantiFERON Gold is a type of blood test that is used to diagnose tuberculosis (primarily latent, or inactive tuberculosis). It was approved by the FDA in 2001 to help detect latent Mycobacterium tuberculosis infections.
How does the QuantiFERON Gold test work?
Answer: QuantiFERON Gold is a type of Interferon-Gamma Release Assay, or IGRA, test. These tests help check for the presence of a response to Mycobacterium tuberculosis.
Why do people get the QuantiFERON Gold test?
Answer: Many people test positive for tuberculosis on the standard medical skin test. Unfortunately, there is a high rate of false positives, usually because of prior vaccination with the Bacille-Calmette-Guerin (BCG) vaccine administered for tuberculosis protection. Until the advent of blood tests like QuantiFERON Gold, people with a positive TB skin test who needed TB clearance would be required to get a chest x-ray (often annually).
What are other advantages to the QuantiFERON Gold test?
Answer: The QuantiFERON Gold test only requires a single visit whereas a PPD, also known as a TB skin test, requires 2 visits (placement and read). Results are often available as soon as 24 hours after the blood draw.
What are disadvantages of a QuantiFERON blood test?
Answer: The test requires a blood draw. Also, the blood has to be handled in a special way or else the test has to be repeated. Finally, acceptance of this test is not fully mainstreamed yet which limits its usefulness in all compliance settings (although this will change over time).
In compliance with the Occupational Safety and Health Administration (OHSA) rule (29 CFR 1910.1030 Bloodborne Pathogens) and Centers for Disease Control (CDC) recommendations, all HCPs with occupational exposure (Categories I and II, Job Classifications) obtain the Hepatitis B Vaccination.
- Category I – Job classification where exposure is anticipated in normal routine of job.
- Category II – Job classification where only occasional exposure is anticipated in normal routine of job.
- Category III – Job classification where no exposure is anticipated in the normal routine of job, however may occur if an emergency is encountered.
The Hepatitis B Vaccine is offered free to all healthcare professionals who are at high risk for exposure to blood or body fluids of patients (Category I and II Job Classifications).
Upon hire, the HCP will be evaluated as to vaccination status and offered the vaccine unless the HCP has:
- Previously received the complete Hepatitis vaccination series (3 immunizations)
- Antibody testing has revealed that the HCP is immune (titer)
- The vaccine is contradicted for medical reasons
If the employee accepts the vaccination, it will be initiated within ten (10) working days of initial assignment.
If the employee refuses the vaccine, the employee will sign a Hepatitis B Vaccine Declination Form. If at a later date, while still employed, the HCP decides to accept the vaccination, the vaccine will be made available at that time.
Currently the Center for Disease Control (CDC) does not recommend a routine booster dose of Hepatitis B vaccine.
Varicella, more commonly known as Chickenpox is a highly contagious illness caused by primary infection with varicella zoster virus (VZV) Chicken pox is spread easily through coughs or sneezes of ill individuals, or through direct contact with secretions from the rash. Following primary infection there is usually lifelong protective immunity from further episodes of chickenpox.
All HCPs must provide evidence of immunity to varicella as required by client contract. Evidence of immunity includes any of the following:
- Documentation of two doses of varicella vaccine;
- Blood tests (titer – see below) showing immunity to varicella or laboratory confirmation of prior disease; or
- History of Disease Form, indicating date of disease (accepted by some clients)
Varicella Titer: In order to show positive immunity, the Varicella titer must reach a level of 1.10. If it’s .90, then there is no immunity and the HCP should be vaccinated. If the titer level is between .91 – 1.09, there is some immunity, but the HCP should have a booster of Varicella vaccine.
All HCPs who have direct patient contact should have documented immunity to Measles, Mumps and Rubella.
Measles (Rubeola) is an infection of the respiratory system caused by a virus, specifically a paramyxovirus of the genus Morbillivirus.
Measles is spread through respiration (contact with fluids from an infected person’s nose and mouth, either directly or through aerosol transmission), and is highly contagious—90% of people without immunity coming in contact with an infected person will catch it. The infection has an average incubation period of 14 days (range 6–19 days) and infectivity lasts from 2–4 days prior, until 2–5 days following the onset of the rash (i.e. 4–9 days infectivity in total).
All HCPs must provide evidence of immunity to Rubeola, when required by client contract. Evidence of immunity includes any of the following:
- Documentation of two doses of MMR or Measles vaccine on or after first birthday;
- Blood tests (titer – see below) showing immunity to Rubeola or laboratory confirmation of prior disease; or
Rubeola Titer: In order to show positive immunity, the Rubeola titer must reach a level of 1.10. If it’s .90, then there is no immunity and the HCP should be vaccinated. If the titer level is between .91 – 1.09, there is some immunity, but the HCP should have a booster of Measles vaccine.
Mumps is a viral disease caused by the mumps virus. Mumps is a contagious disease that is spread from person-to-person through contact with respiratory secretions such as saliva from an infected person. When an infected person coughs or sneezes, the droplets aerosolize and can enter the eyes, nose, or mouth of another person. Sharing food, sharing drinks, and kissing can also spread mumps. The virus can also survive on surfaces and then be spread after contact in a similar manner.
All healthcare professionals must provide evidence of immunity to Mumps, when required by client contract. Evidence of immunity includes any of the following:
- Documentation of Mumps vaccine on or after the first birthday;
- Blood tests (titer – see below) showing immunity to Mumps or laboratory confirmation of prior disease; or
- Receipt from a healthcare provider of a) a diagnosis of Mumps; or b) verification of a history of Mumps.
Mumps Titer: In order to show positive immunity, the Mumps titer must reach a level of 1.10. If it’s .90, then there is no immunity and the HCP should be vaccinated. If the titer level is between .91 – 1.09, there is some immunity, but the HCP should have a booster of Mumps vaccine.
Rubella, commonly known as German measles, is a disease caused by the rubella virus. The virus is transmitted by the respiratory route and replicates in the nasopharynx and lymph nodes. The virus is found in the blood 5 to 7 days after infection and spreads throughout the body. The virus has teratogenic properties and is capable of crossing the placenta and infecting the fetus where it stops cells from developing or destroys them.
All HCPs must provide evidence of immunity to Rubella, when required by client contract. Evidence of immunity includes any of the following:
- Documentation of two doses of MMR or Rubella vaccine on or after first birthday;
- Blood tests (titer – see below) showing immunity to Rubella or laboratory confirmation of prior disease; or
Pregnancy is a contraindication to vaccination against measles, mumps and/or rubella. Vaccine should not be given to pregnant women or those who may become pregnant within three (3) months of vaccination.
Rubella Titer: In order to show positive immunity, the Rubella titer must reach a level of 1.10. If it’s .90, then there is no immunity and the HCP should be vaccinated. If the titer level is between .91 – 1.09, there is some immunity, but the HCP should have a booster of Rubella vaccine.