AHPRA Registration and changes to the renewal questions

This year there are changes to the renewal questions about working with blood borne viruses.

Each year you have been asked to declare you are aware of your infection status for blood borne viruses and to comply with the CDNA Guidelines and the Board’s Guidelines on infection control.

However, the CDNA Guidelines have recently been revised, and so the questions asked by the Board have also been updated. The only major change to the CDNA Guidelines is that for practitioners performing exposure prone procedures (EPPs) the minimum blood testing frequency is three years.

The effect of the changes
From a registration point of view, if you answer yes to performing EPPs, there is no change in what you must do – that is to be aware of your blood borne virus status and to comply with the CDNA Guidelines and the Board’s Guidelines on infection control.

Your obligations

What is an Exposure Prone Procedure?
An EPP is a procedure where there is a risk of injury to the health care worker (HCW) resulting in exposure of the patient’s open tissues to the blood of the HCW. These procedures include those where the HCW’s hands (whether gloved or not) may be in contact with sharp instruments, needle tips or sharp tissues (spicules of bone or teeth) inside a patient’s open body cavity, wound or confined anatomical space where the hands or fingertips may not be completely visible at all times.

The CDNA Guidelines example EPPs in dentistry as maxillofacial surgery and oral surgical procedures, including the extraction of teeth (but excluding extraction of highly mobile or exfoliating teeth), periodontal surgical procedures, endodontic surgical procedures, and implant surgical procedures. This list is non-exhaustive. Other obvious examples would include jaw fracture reductions, extensive soft tissue trauma, and bony reconstruction.

What if you are a general dentist practising routine dentistry?
In a general dental setting it is still conceivable that you may come in contact with sharp instruments, needle tips or sharp tissues (spicules of bone or teeth) inside a patient’s oral cavity. Even a routine restoration may involve the use of sharps and operative burs. Unless you are practising a very limited scope of dentistry, it is likely as a general dentist you will perform EPPs.

Do I have to test for HIV, Hepatitis C and Hepatitis B(HBV) once every three years?
Yes, in order to be compliant with the revised CDNA Guidelines you must test every three years. If you do not and you knowingly make a false declaration to AHPRA you are at risk of having action taken against you for unprofessional conduct. As a registered practitioner you are therefore required to undergo a blood test at least once every three years.
If you have demonstrated immunity to HBV you do not have to test for that virus.

Can I perform EPPs if I have a blood borne virus?
Yes, but there are things you must do to ensure the safety of you and your patients. If you are recently diagnosed with a blood borne virus you should stop performing EPPs immediately and refer to the CDNA Guidelines.

Do I have to tell AHPRA I have a blood borne virus?
No. If you are a dental practitioner living with a blood borne virus you do not need to notify AHPRA about your infection if you are following your treating practitioner’s advice and have complied with, and are continuing to comply with, the CDNA guidelines. However, if you do not comply with your treating practitioner’s advice, the treating practitioner may have to report you to AHPRA.

Do I have to declare a blood borne virus as an impairment?
No. When applying for and renewing registration, you are required to declare whether or not you have an impairment. A blood borne virus in itself does not constitute an impairment.
However, if you are a dental practitioner with a blood borne virus who is not complying with the CDNA guidelines you are considered to have an impairment because you have a condition that ‘detrimentally affects your capacity to practise the profession’. In that circumstance, you must declare that you are impaired.

Additional resources

For more information about your obligations you can refer to the following sources:
1. Australian National Guidelines for the Management of Healthcare Workers Living with Blood Borne Viruses and Healthcare Workers who Perform Exposure Prone Procedures at Risk of Exposure to Blood Borne Viruses
2. Public consultation on Guidelines for registered health practitioners and students in relation to blood borne viruses

 

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