Trainee Exposure to Bodily Fluids Policy

To whom this policy applies

Any student in University of Nevada Reno, School of Medicine programs that include curricular and/or co-curricular patient care activities with exception of Graduate Medical Education (GME) trainees who must follow GME Policy.

Definitions

Exposure: Needle stick or sharps injury, or exposure to blood or other bodily fluids

Purpose/background

The purpose of this policy is to inform trainees, medical providers, faculty, and affiliated hospitals and clinics of their responsibilities and required procedures for trainees to complete following a bodily fluid exposure.

Trainees are potentially exposed to patients with infectious diseases. All trainees at UNR Med will be educated and trained to prevent or reduce exposure to infectious and environmental hazards. For this reason, procedures exist to inform trainees of potential risk and teach techniques and procedures designed to decrease or avoid exposure.

Policy

It is the policy of UNR Med to:

  1. Provide education to trainees to help prevent exposures
  2. Provide clear procedures to address these events when they do occur
  3. Make the procedural information easy to access

Responsibilities & procedures 

Education

  1. OSHA Training: Trainees are introduced to the concept of infection control and work-related exposure within one year of matriculation via annual mandatory online training. Trainees must complete OSHA training each year and be certified in order maintain enrollment in their UNR Med program. As a result of this training, trainees are expected to understand and comply with the following procedures
    1. Universal precautions
    2. Needle/sharps safety
    3. Use of protective equipment
    4. Isolation guidelines
  2. HIPAA Compliance: Trainees are expected to comply with all aspects of their HIPAA training including not accessing patient medical records during an exposure incident.

Procedure for initial trainee exposure 

Trainee responsibilities

  1. Remove all soiled clothing. Wash needle stick site immediately with soap and water.  Flush splashes to nose, mouth, or skin with water.  Irrigate eyes with clean water, saline or sterile irrigant. Immediately report the exposure to the attending physician, resident, preceptor/course director and/or faculty supervisor as required per program.
  2. Seek immediate evaluation
    1. Proceed to the UNR Student Health Center, Emergency Department of the facility where the exposure occurred or the nearest available Emergency Department
    2. For away electives, follow the procedures of the host institution.
  3. Report the exposure to the UNR Student Health Center at (775) 784-6598 if evaluation was at a site other than the UNR Student Health Center and complete the Incident Report if not already completed.
  4. Report the exposure to the designated individual based on the program of study.
    1. Medical trainees must report the exposure to the UNR Med Associate Dean for Student Affairs within 24 hours.
    2. Physician Assistant trainees must report the exposure to PA Office of Admissions and Student Affairs.
    3. Speech Pathology and Audiology trainees must report the exposure to the SPA Department Safety Officer.
  5. Students should advise the facility that they are not an employee and a Worker’s Compensation Report should not be filed.

Faculty/resident responsibilities

  1. Faculty and residents will direct trainees to the appropriate facility for treatment per this policy.
  2. Any faculty member or resident who is informed by a trainee of an exposure must report this exposure to the designated student affairs official or designated departmental safety individual within 24 hours.
  3. The designated individual will communicate with the clinical site where the exposure occurred to ensure the site-specific procedures following a fluid exposure are aligned with the UNR Med procedures.
  4. Exposure reports will be reviewed quarterly by representatives from compliance, UNR Student Health Center and student affairs representatives from the respective programs.

General guidelines and information - exposure and treatment follow-up 

  • Fees associated with the testing and treatment are covered by the Student Health Insurance, pursuant to coverage limitations and deductibles. Trainees who choose to waive the student health insurance plan may or may not be covered by their personal plan’s benefits and may have additional expenses related to exposures.
  • Trainees who desire counseling should contact the designated Student Affairs individual for their program. 
  • Initial and follow-up laboratory studies will be ordered and monitored by the UNR Student Health Center. If laboratory tests are completed at another facility, copies of the test results must be forwarded to the UNR Student Health Center. The Student Health Center will maintain these records in a secure and confidential location and send reminders for follow up testing.
  • Initial testing includes, but is not limited to: HIV, Hepatitis B, Hepatitis C.
  • Follow up testing should be conducted at six weeks, three months, and six months.
  • Students who receive a positive test result related to contraction of a transmissible disease should refer to the Student Transmissible Disease Policy.
  • Trainees who do not send the proper documentation of laboratory or other follow-up treatment will receive a reminder email. If there is no response to the reminder email, a certified letter will be sent to the trainee reminding them of the importance of follow-up. If there is no response to the certified letter, no further attempts will be made to contact the trainee. The trainee will then be responsible for any further care.

Review 

Approved by Medical Education Steering Committee, 03/27/2025