All staff are given education, information and training about hepatitis C, at orientation and with updates and refreshers through the course of their work within custodial services. Training should address matters relating to attitudes and values.
Some of the compelling reasons that custodial services staff, both custodial and health, become experts in their respective fields for hepatitis C prevention, treatment and care include:
- custodial facilities have an obligation to take reasonable measures to effectively manage all foreseeable risks of harm to inmates,including exposure to blood borne viruses such as hepatitis C;
- inmates will return to society after their imprisonment and their health is an issue of concern to the general community;
- the health of inmates is important for the occupational health and safety of the staff of custodial facilities.
The prevalence of hepatitis C in prisons is very high among inmates. It can be very infectious if the conditions for transmission are suitable. This makes awareness of hepatitis C an inevitable fact in the workplace. Training and education that is tailored to staff requirements is extremely important to prevent and minimise chances for accidental transmission of hepatitis C. Such programs are designed to provide introductory information on orientation and build on this with practical training and regular updates. Hepatitis C is a workforce issue for all employees and their employers, although opportunities for exposure and preventative and protective strategies will vary with work duties. Additionally, staff must be provided with the necessary equipment, that is accessible, to respond to exposures.
The workforce is defined as the custodial staff, non custodial administrative and support staff, health care workers, including authorised volunteers, official visitors and the like in the custodial setting. Workforce matters will be better progressed if they are approached collaboratively with unions and industrial organisations including occupational health and safety standards and work-cover authorities. Such matters may also be incorporated into workplace agreements or similar contracts.
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7.1 The custodial workforceCustodial staff are responsible for the management of the custodial setting and should be given every opportunity to understand hepatitis C, its epidemiology, transmission, prevention, care, management and treatment and the practical on the job consequences of working with a population with high levels of infection. Existing staff will need to have access to ongoing training in all aspects of hepatitis C. New staff should receive education about all aspects of hepatitis C as part of their induction and on-the-job training programs, including ‘lockdown training’.
While each custodial facility will need to develop resources and delivery strategies particular to their institution, there are considerable resources in the community which can be drawn on to facilitate this. Linkages with community based agencies and professional organisations will assist these collaborative strategies. The make up of the custodial population will influence the type of information required. Training must include, but must not be limited to, infection control strategies and should address attitudes and values.
In addition to any on the job training any programs providing pre-service training must include education on blood borne viruses. Along with transmission, prevention and treatment related issues such education must address matters relating to attitudes and values.
Educating custodial staff will also assist custodial authorities to meet their occupational health and safety obligations to their employees, contractors and others in the workplace.
7.2 Health Service WorkforceAll health care workers require education about hepatitis C. However, the high prevalence of hepatitis C in the custodial environment requires that the all health workforce within the prison setting develop and maintain a higher level of knowledge and expertise about hepatitis C. The information and education needs of the custodial health workforce are not vastly different than that required by the health workforce in the community. Custodial health services should make use of training opportunities provided in the community. Such linkages will facilitate assessment, health, monitoring and treatment in the facility and assist in post care planning and service delivery.
Staff training must complement the introduction of any treatment or health management strategies. Mentoring of nursing staff, by collaborating community treatment services has proved useful in a number of settings.
Particular attention will need to be given to staff involved in testing and related activities so that these individuals are appropriately equipped to provide education and support. Corrective Services are responsible for ensuring that medical staff have appropriate hepatitis C training and education to understand and manage the health needs of inmates.