/Institutions/University-of-Texas-Rio-Grande-Valley/json/som/policies-local.json

/Institutions/University-of-Texas-Rio-Grande-Valley/json/som/policies.json

EAA030 Student Exposure to Infectious and Environmental Hazards

Policy Number: EAA030
Policy Title: Student Exposure to Infectious and Environmental Hazards

A. Purpose

The purpose of this policy is to educate and prevent student exposure to infectious and environmental hazards and to provide clear procedures and guidelines on how to proceed in the event a student is exposed to such hazards.

B. Persons Affected

This policy will cover students participating in the UTRGV School of Medicine (UTRGV SOM) curriculum.

C. Policy

The UTRGV SOM supports practices which secure the health of our students, staff, and faculty. The SOM particularly seeks to mitigate the potential harms which may come to a student who experiences an accidental exposure to blood-borne pathogens, through inadvertent needlestick or other route. To that end, the SOM has developed guidance and procedures for our students to follow in the event of such exposure, and further the SOM has deployed resources in Student Health Services and Employee Health Services to help students and others deal with these exposures.

Education and Evaluation

All students at UTRGV SOM and students visiting UTRGV SOM shall receive personal safety and environmental exposures training. 

UTRGV SOM will provide all medical students an orientation to the infectious and environmental hazards policy of the affiliate hospital prior to commencing laboratory and/or patient care activities.

Those students with an occupational exposure to a blood borne pathogen shall have the exposure evaluated and documented by a healthcare provider following the applicable post-exposure protocol described in Appendix A of this policy.

Infection Control

Medical students, like all health care workers, bear a responsibility to prevent the spread of infection. Pursuant to that responsibility, medical students will follow universal precautions at all times.

Blood, semen, and vaginal fluids are the three most potentially infectious body fluid but other body fluids such as cerebrospinal fluid, synovial fluid, pericardial fluid, peritoneal fluid, amniotic fluid, and unfixed body tissues should be considered potentially infectious, especially if contaminated with blood. Universal precautions should always be followed, even when handling fluids and tissues that are not normally infectious such as saliva, feces, urine, sweat, sputum, vomitus, and tears; it should be noted that these body fluids carry a greater risk of infection if contaminated with visible blood, which can result from an accidental occurrence or complication of patient contact and procedures.

Students are required to follow appropriate infection control procedures, including the use of personal protective equipment, whenever there is a risk of parenteral, cutaneous, or mucous membrane exposure to blood, body fluids, or aerosolized secretions from any patient, irrespective of the perceived risk of a blood borne or airborne pathogen. Regardless of the real or perceived communicable disease status of the patient, all students and staff should follow standard universal precautions when providing patient care.

UTRGV SOM adheres to the institutional policies of the University of Texas system regarding exposure to infectious and environmental hazards on campus, and the institutional policies of its clinical affiliates regarding exposure to infectious and environmental hazards. If a student sustains a needlestick, sharp puncture, or other exposure to body fluids, the faculty will ensure that the student is able to seek post-exposure prophylaxis (PEP) within two hours of exposure after the needlestick, sharp puncture, or body fluids exposure. Faculty will provide the student with the name, address, and phone number of the nearest health care facility or emergency room that can provide PEP care. In addition, Student Health Services is prepared to provide HIV post exposure prophylaxis intervention if indicated.

Implications on Learning Activities

Students infected with bloodborne or other pathogens shall not, solely because of such infection, be excluded from participation in any phase of medical school life, including educational opportunities, employment, and extracurricular activities, except as otherwise required by applicable federal, state, or local law, or unless their health condition presents a direct threat to the health and safety of themselves or others. Students infected with airborne pathogens are excluded from participation in such activities during the infectious stage of their disease. Students who know or who have reasonable basis for believing that they are infected with bloodborne or airborne pathogens, are expected to seek medical care at the UTRGV campus clinics or from their private physician. Students will be excused from clinical activities in order to seek medical care.

This policy aims to protect students and faculty from the risks of being occupationally infected with the Human Immunodeficiency Virus (HIV), hepatitis B virus, or other bloodborne pathogens, and to implement the United States Department of Labor Occupational Safety and Health Administration (OSHA) Standard 29 CFR Section 1910.1030 Bloodborne Pathogens, which can be found at:
https://www.osha.gov/SLTC/bloodbornepathogens/bloodborne_quickref.htmI

APPENDIX A

PROCEDURES FOR STUDENT EPOSURE TO INFECTIOUS DISEASE

Prevention and Education Protocol

All students will receive training in universal precautions prior to seeing patients. This training will meet the minimum requirements for students as outlined in The University of Texas Rio Grande Valley Bloodborne Pathogen Exposure Control Plan at this link: https://www.utrgv.edu/ehsrm/_files/documents/lab-safety/bloodborne-pathogen-control-plan.pdf

Students must complete the following safety modules yearly:

-OSHA Blood Borne Pathogens (BBP)
-Airborne exposures (i.e. Tuberculosis) Safety Training
-Active Shooter Training
-Infection Control

All medical students will also receive an orientation to the infectious and environmental hazards policy of the affiliate hospital prior to commencing laboratory and/or patient care activities.

The sponsoring host faculty member at UTRGV SOM is responsible for ensuring that all visiting students receive the appropriate training and orientation prior to starting laboratory or clinical work at UTRGV or one of its clinical affiliates. In addition, the sponsoring host faculty member is responsible for ensuring the proper procedures are followed in the event of potential exposure.

Infection Control Precautions

• Always wash hands before and after patient contact, according to the policy of the clinical site, even if gloves are used.
• Always wear gloves when exposure to blood, body fluids, and other body excretions is likely.
• Use gloves appropriately according to aseptic and/or sterile techniques and always change gloves between patients.
• Wear gowns/aprons when soiling of clothing with blood or body fluids is likely.
• Wear masks, face shields, and eye protection when aerosolization of blood or body fluids may occur.
• Dispose of sharps in designated rigid sharp containers. Never recap needles by hand.
• Dispose of waste saturated with blood or body fluids in designated red biohazardous waste containers

Post-Exposure Protocol

Handling of and exposure to body fluids is routine in medical practice. Hazardous exposure - a needle stick or splash or inhalation - is not routine but may nevertheless happen. If you are exposed in a potentially hazardous way, please remember to take these steps:

1. Apply first aid. Wash and rinse the wound or exposed area thoroughly with soap and water.
2. Say something. Report the exposure promptly to an attending or resident or charge nurse and Student Health Services. Especially for a needle stick blood exposure, timing is crucial. According to the CDC, evaluation and initiation of preventive treatment, if indicated, should occur within 2 hours of exposure.
3. Get care in the nearest facility you can access within 2 hours. If you are at one of our partner hospitals, go to the ER. If you are in an office or clinic, speak to your faculty preceptor. Comply with all policies and procedures at the clinical site, including creating an Incident Report and having yourself and the source patient tested.
4. Follow the protocol. If a potentially hazardous exposure occurred, then have blood drawn from you to be tested for HIV antibody, Hep B surface antigen, and Hep C antibody as well as from the source patient.
5. Get PEP - post-exposure prophylaxis - if indicated. This is not a judgment you should make by yourself but rather by a clinician at your site. If in doubt, or if no one is immediately available, call Student Health Service (665-2511) or Dean on Call (296-2502).

Follow-up with Student Health Services. Complete paperwork - file insurance claim to cover charges for care - arrange to receive results of tests. Student Health Services can be reached at 956-665-2511 during working hours. If the exposure occurs after working hours, report to Student Health Services promptly on the next working day following the exposure.

Post-exposure protocol is also presented in a graphic form in Appendix B.

Financial Responsibility

If the above protocol is followed, cost of medical services received for needle stick or body-fluid exposure will be reimbursed by UTRGV, up to $500 per case. The reimbursement shall be processed by the Student Health Services after the student submits a medical insurance claim receipt for the same case. In order to be eligible to receive the benefit, each UTRGV student must comply with the following requirements:

1. Each student must consult the Student Health Services at 956-665-2511 immediately.
2. Each student must seek reimbursement from the student's private insurance company first.
3. The student must initiate the request for reimbursement from UTRGV within 30 days from the date the student 's insurance claim is approved/denied.
4. Each student must provide the Student Health Services with a written report of the incident prior to making any request for reimbursement which must include time, date, and location of incident. The incident must relate to your clinical duties as a registered student at UTRGV.

APPENDIX B 

UTRGV SOM Needlestick Protocol

Guidelines for Needle Stick and Body Fluid Exposures for UTRGV Students