CMSV 339 Exposure to Infectious and Environmental Hazards Policy

Policy Name: Exposure to Infectious and Environmental Hazards Policy

Prevention
The College of Mount Saint Vincent Master of Science Physician Assistant Program follows the guidelines and recommendations of the Centers for Disease Control and Prevention (CDC) and the Occupational Safety and Health Administration (OSHA) regarding the use of standard precautions to prevent the spread of infection and reduce occupational exposure to blood and body fluid pathogens. Current CDC recommendations for Standard Precautions include:

1. Proper hand hygiene:

    1. Hands should be washed with soap and water if hands are visibly dirty or soiled with blood or other body fluids, or after caring for patients with known or suspected infectious diarrhea.
    2. If hands are not visibly soiled, an alcohol-based hand rub may be used.
    3. Hands should be washed in each of the following instances:
      • Before touching a patient, even if gloves will be worn.
      • After contact with a patient’s intact skin.
      • After removing gloves.
      • After any contact with body fluids or excretions, mucus membranes, non-intact skin, and wound dressings.
      • After contact with inanimate objects, including medical equipment, in the immediate vicinity of the patient.
      • Before eating and after using a restroom.

2. Use of personal protective equipment (gloves, gown, mask, etc.):

    1. Gloves must be worn when there is a risk of contact with or when handling blood or body fluids or when there is potential for contact with mucous membranes, non-intact skin, or contaminated equipment.
    2. Masks, protective eyewear, and gowns must be worn along with gloves when performing or assisting with procedures with a risk of body fluid or other hazardous materials splashes or sprays.

3. Safe use of injections and sharps:

  1. Work in well-lit areas and keep sharps disposal containers within easy reach.
  2. Use self-sheathing needles and needleless systems when possible.
  3. Do not recap needles unless required by the specific procedure being performed.
  4. Keep exposed sharps in your view and be aware of people around you.
  5. Place all needles and disposable sharps in designated puncture resistant containers as soon as possible after use.
  6. Keep fingers away from the opening of sharps containers.

4. Safe handling of potentially contaminated surfaces or equipment:

  1. Areas in which patient care activities are performed should be cleaned and disinfected at the conclusion of the procedure.
  2. Reusable medical equipment should be cleaned and disinfected (or sterilized) according to the manufacturer’s instructions.

5. Respiratory hygiene/cough etiquette:

  1. Cover your mouth with a tissue when coughing or sneezing.
  2. Use the nearest waste receptacle to dispose of tissue after use.
  3. Perform hand hygiene after contact with respiratory secretions and contaminated objects.
  4. Wear a mask when examining a patient with symptoms of a respiratory infection.

Before any patient care or laboratory experience occurs, all College of Mount Saint Vincent Master of Science Physician Assistant Program students must complete yearly OSHA training and education regarding needle stick/sharps procedures and prevention of blood borne pathogens. The course is available here.

Each rotation site for students should have a working needle stick/sharps policy in place. Before beginning any rotation, a student must complete any site-specific safety and security training requirements if required by the institution.

Students must notify the program’s director of medical education/academic coordinator and either the course director or the course instructor (if in the didactic phase) or the director of clinical education/clinical coordinator (if in the clinical phase) as soon as possible following any exposure to bodily fluids or potentially serious infectious disease.

Post-Exposure Control
Should an exposure to blood and/or other body fluid or a needle stick injury occur, the procedure for obtaining appropriate medical care is as follows:

  1. When an exposure occurs: Wounds and skin sites that have been in contact with blood or body fluids should be washed with soap and water; eyes and mucous membranes should be flushed with water if there has been a contact with blood or body fluids. There is no evidence that the use of antiseptics for wound care or expressing fluid by squeezing the wound further reduces the risk for HIV transmission. However, the use of antiseptics is not contraindicated. Use of caustic agents (e.g. bleach), is not recommended.
  2. All exposures to blood or body fluids must be reported immediately to the preceptor and to the program’s director of clinical education. The director of clinical education will assist in the notification of the appropriate medical care providers (employee health office, nursing supervisor, or emergency department, if applicable) that the student is reporting to them for initiation of exposure to blood borne pathogen protocol and ensure that the plan is working smoothly. The DCE will make sure that the student is appropriately excused from the rotation to complete this workup.
  3. Medical Evaluation: It is extremely important that medical evaluation takes place immediately because treatment decisions must be made within two (2) hours of exposure. HIV prophylaxis for high-risk exposure appears most effective if started within 2–4 hours. It is also extremely important to evaluate the donor’s risk status immediately.
  4. Medical Evaluation Facilities:
    1. If the incident occurs on the College campus during regular working hours, the student should report it immediately to the College’s Master of Science Physician Assistant Program office located on the 4th floor of Founders Hall. If an incident occurs outside of regular College of Mount Saint Vincent school hours, the student must notify the program director or the director of clinical education as soon as possible.
    2. If the incident occurs during a supervised clinical rotation (SCPE) outside of campus, the student should follow the infection control policy and procedures required for that facility. In the absence of a specific facility policy regarding exposures, the student should report immediately to the nearest emergency department for evaluation and treatment, and notify the program director and the director of clinical education as soon as possible.

Financial Responsibility and Program Participation 

  1. Financial responsibility: Students will be financially responsible for all costs incurred during compliance with this policy, including emergency treatment, laboratory evaluation, medical treatment, and follow-up care.
  2. Program participation: Continued participation in the activities of the program will not be affected by any injury or illness that occurs while enrolled, provided the student continues to meet all technical standards and fulfill all defined requirements for program progression, and is not directly infectious by way of routine contact.