Trainee Exposure to Bodily Fluids Policy

To whom this policy applies

All trainees enrolled in clinical programs or electives at the University of Nevada, Reno School of Medicine (UNR Med) with exception of Graduate Medical Education (GME) trainees who must follow GME Policy.

Who needs to know this policy

UNR Med trainees; visiting students; faculty; staff; and affiliated hospitals and clinics, including the Student Outreach Clinic.

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

Definitions

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

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
    • Universal precautions
    • Needle/sharps safety
    • Use of protective equipment
    • Isolation guidelines

Procedure for initial trainee exposure

Trainee responsibilities

  1. Remove soiled clothing and wash the exposed areas with soap and water.
  2. Immediately report the exposure to the attending physician, resident, preceptor/course director and/or faculty supervisor as required per program.
  3. Seek immediate evaluation
    1. Reno
      1. Immediately seek evaluation at the UNR Student Health Center or in the Emergency Department of the facility where the exposure occurred.
    2. Other Locations
      1. Immediately seek evaluation in the Emergency Department of the facility where the exposure occurred or the nearest Emergency Department.
      2. For away electives, follow the procedures of the host institution.
  4. Report the exposure to the UNR Student Health Center at (775) 784-6598 and complete the Incident Report if not already completed.
  5. 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 Admissions and 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.
  6. Advise facility that you are not an employee and they should not file a Worker's Compensation Report

Faculty/Resident Responsibilities

  1. Faculty and residents will direct trainees to the appropriate facility 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.

General guidelines and information - exposure and treatment follow-up

  • Fees associated with the testing and treatment are covered by the Student Health Insurance. 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.
  • 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.