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Guidelines for Exposure to Infectious and Environmental Hazards (A3.08a-c)

Infectious/Communicable Disease Training and Post-Exposure

In order to minimize the risk of contracting any infection in the course of their clinical practice activities learners must follow the Universal Blood and Body Fluid Precautions developed by the Centers for Disease Control (CDC). Instruction regarding environmental hazards and infectious exposures is provided during the didactic phase of the program and reviewed prior to entering the clinical phase of the program. Upon completion of the module learners are expected to consistently and appropriately implement Universal Precautions and other appropriate safety measures thereafter. It is the learner’s responsibility to become familiar with the policies and procedures for employing these precautions at each of the clinical sites to which the learner is assigned. All learners will participate in the clinical affiliation requirements for safety and quality assurance compliance at the direction of the clinical affiliation personnel.

Guidelines for Learner Exposure to Infectious and Environmental Hazards Blood and body fluid exposure (HIV, Hepatitis B, Hepatitis C)

An “exposure incident” refers to a specific eye, mouth, other mucous membrane, non-intact skin, or parenteral contact with blood or other potentially infectious materials that results from the performance of a learner’s clinical duties. Should a patient’s blood or body fluid come into contact with a learner or if a patient comes in contact with the blood or body fluid of a learner, the learner should seek medical treatment IMMEDIATELY and follow the procedure outlined below:

  •  Decontamination of exposed site – vigorous flushing of mucous membranes, eyes, and/or thorough hand washing.
  •  Immediately report incident to appropriate clinical site personnel, including your preceptor, and follow established protocol for the site.
  • If there is no established protocol, seek treatment at the nearest Emergency Department.
  • Seek medical attention to ensure appropriate medical care relating to the exposure is provided.
    • This should occur within 2 hours for a known HIV infected source and 4-6 hours for all other exposures.
    • The appropriate initial site to seek medical attention varies based on the clinical site where the incident occurred. It could be an Occupational Health or Emergency Department at the institution or you many need to find the nearest Emergency Department. Learners should review site-specific exposure protocol.
    • Management may include confidential testing of the patient and the learner for hepatitis B, hepatitis C, HIV and other infectious agents.
    • In the event that additional follow-up medical care is necessary, learners will need to refer to site specific protocol to discover whether this will continue to be provided by the initial site or if the learner should arrange follow-up with their own health care provider.
  • Report the event via e-mail to the Director of Clinical Education or the Program Director within 24 hours of the event.

Please refer to the Updated U.S. Public Health Service Guidelines for the Management of Occupational Exposures to HBV, HCV, and HIV and Recommendations for Postexposure Prophylaxis

Other Exposures, Illness, or Injury

For learner and patient safety, learners who have been exposed to a contagious disease or are ill with symptoms of contagious diseases may need to avoid contact with patients. In such cases, or in the event of an injury, the learner should be evaluated by a health care provider in order to determine need for therapy and clearance for patient care. Learners must notify and work with the site preceptor to determine whether the situation requires the learner to be evaluated by the site occupational health provider or their own health care provider. Learners must report via email such instances to the Director of Clinical Education or the Program Director within 24 hours of the event.

Medical Follow-up and Clearance to Return to Clinical Activities

Initial and subsequent care and follow-up activities including recommendations related to counseling, prophylactic/treatment regimens, and continued or restricted practice activities following a learner’s exposure incident/illness/injury will be determined by the learner’s health care provider (in collaboration with the learner) and other appropriate health care professionals. The learner must obtain a medical attestation form from their healthcare provider clearing the learner for participation in patient care.

Financial Responsibility

All learners are required to carry medical insurance to cover the expense of such unlikely event and provide coverage for the laboratory testing and treatments that may be required. Costs not covered by insurance are the responsibility of the learner.

Effects of Exposure/Illness/Injury on Learner Learning Activities

Learners may not be able to return to a specific clinical affiliate and/or meet the required technical standards due to effects of clinical exposure to infectious and environmental agents. In such case the APPRC will review the case and make recommendations regarding the learner’s academic standing.

Learners should refer to the remediation, deceleration and progression policies regarding criteria for academic separation.