Are you evaluating a health care worker?

Did the worker?

• have a direct contact with blood or body fluids?

• have an injury with a needle, broken glass, scalpel, scissors or other sharp object?

• have an exposure to a body fluid from a Hbe antigen positive patient?

• have exposure to a variant strain of HBV with antigens not targeted by protective antibodies?

• refuse hepatitis B vaccination?

• have an incomplete vaccination series against HBV?

• fail to use personal protective equipment appropriately?

Does the health care worker work?

• in the emergency department?

• in the laboratory?

• in the operating room?

• with an IV team?

• in oral surgery or dentistry?

• in the hemodialysis unit?

• on the infectious diseases ward?

• in the intensive care unit?

• in an area where there was a failure to properly clean up a blood spill?

• in an area where a viricidal agent is not used during routine cleaning?

Was the source patient?

• being hemodialyzed?

• an intravenous drug abuser?

• a homosexual or bisexual man?

• a prison inmate?

• developmentally disabled?

• an immigrant from or resident of a highly endemic area?

• an inner city resident?

• a spouse or partner of a patient with active HBV?


Please fill out required fields.