CMSV 322 Exposure, Needlestick, Blood Borne Pathogens, Injury

Policy Name: Exposure, Needlesticks, Blood Borne Pathogens, Injury

The College of Mount Saint Vincent has policies in place that effectively address exposure to environmental hazards, including:

• The education of PA students about methods of prevention.
• The procedures for care and treatment after exposure, including a definition of financial responsibility.
• The effects of infectious and environmental disease or disability on medical student learning activities.

Standard Exposure

• Standard Precautions
  • Consider blood, body fluids, and tissue from all patients to be potentially infectious.
  • Perform hand hygiene before/after all patient contacts.
  • Wear gloves when exposure to blood and body fluids may occur (e.g., during phlebotomy). Change your gloves and perform hand hygiene after each procedure and before contact with another patient.
  • Wear a gown, mask, and goggles when blood or body fluids splashes may occur (e.g., during surgery, placing nasogastric tubes, etc.).
  • Immediately report all incidents of blood and body fluid exposure of the following types:
• • • Parenteral: needle stick, puncture, or cut.
    • Mucous membrane: splash to eyes, nose, mouth.
    • Cutaneous: contact with blood and body fluids on ungloved hands or other skin surfaces that may be cut, chapped, abraded, or affected by active dermatitis.
• High-Risk Exposure
  • Needle stick, especially hollow-bore needles and/or deep injury.
  • Other percutaneous injuries such as cuts.
  • Source patient with known untreated or poorly controlled infection with HIV/HBV/HCV.
• Lower-Risk Exposure
  • Mucous membrane splash.
  • Non-intact skin splash.
  • Human bite with blood exposure.
• Exposure Management
  • Possible Hepatitis B, Hepatitis C, HIV exposure.
• Immediate Response to Exposure
  • Clean wounds or punctures with soap and water.
  • Flush mucous membranes or skin copiously with water or saline.
  • Do not force bleed the wound.
  • Do not apply caustics (e.g., bleach, organic solvents, hard surface disinfectants, etc.).
• Post-Response to Exposure
  • Exposed Healthcare Worker
    • Hepatitis B and C antibody tests.
    • HIV test (4th generation).
    • If HIV PEP will be used: CBC, electrolytes, BUN/creatinine, LFTs, pregnancy test.
  • Source of Exposure
    • Hepatitis B surface antigen.
    • Hepatitis C RNA test.
    • HIV test (4th generation).
• General Treatment
  • Tetanus toxoid (if needed).
  • No specific treatment if HCV (+) source.
• Hepatitis-B Specific Management
  • Hepatitis B vaccine (if not immune).
  • Hepatitis B Immune Globulin (HBIG) if not immune and known Hepatitis B surface antigen (+) source.
• HIV PEP
  • May be indicated, prescribed according to CDC guidelines based on severity of injury and risk of source patient.

On-Campus Incident | Exposure, Needlesticks, Blood Borne Pathogens, Injury
Exposure incidents can occur for a variety of reason. The main concern regarding any exposure incident is prompt and immediate care, as well as initiated treatment.

In response to an incident which takes place within the confines of the College of Mount Saint Vincent campus, including needlesticks, exposure to blood borne pathogens, or bodily fluids (urine, feces, sputum etc.), or any bodily injury sustained the student, is obligated to apply with all accident and injury protocols established by the Master of Science Physician Assistant Program. Protocols are as follows:

• Notification must made to either the program director, academic or clinical coordinator, or any principal faculty member immediately, or as quickly as timer allows, but not later then 48-hours.
• Notification must be made to campus safety and security and an incident report initiated.
• Go directly to either your primary care physician, CMSV-preferred healthcare provider (if open), or the nearest emergency department to receive medical evaluation and treatment.
• A copy of your discharge information sheet with date and time of treatment rendered clearly stated.
• Notification to either the program director and academic/clinical coordinator if student will be needing time away from academic or clinical duties as per treatment plan.
• Please note: If the incident occurred in the College’s Clinical Education Laboratory/Simulation Lab (CEL), the director of the lab must also be notified.

Off-Campus Incident | Exposure, Needlesticks, Blood Borne Pathogens, Injury
If the injury occurs as a result of a school related accident including needle-stick injuries, the student must comply with all accident and injury protocols established by the institution/clinical setting.

If you have a needle-stick injury, or other related injury, go directly to the affiliate organization’s emergency room/department (if available), the nearest emergency room, or private healthcare provider to receive medical evaluation, treatment, and follow-up care.

• The student has the right to refuse medical evaluation and treatment.

It may also be required that students follow up with the risk management department of the healthcare affiliate organization, as well as any other offices as required by the College’s clinical affiliate agreement, or as deemed appropriate by the clinical preceptor.

• The student has the right to refuse recommended medical treatment at the clinical site.

All injuries and occupational exposures must be reported to the program no later than 48 hours following the incident to either the academic/clinical coordinator, senior staff associate, and program director, as well as the director for campus safety and security.

• A copy of your discharge documentation from the treating medical provider or institution must be submitted with the incident report.

All students are required to maintain health insurance while enrolled in the program. Students are responsible for their own healthcare while in school. All expenses related to the injury or exposure are the responsibility of the student.