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Blood and Body Fluid Exposure Reporting

Prevent exposure: Standard Precautions

If you have been exposed: This material is presented for information only. This is NOT an interactive program. You will need to make the telephone calls or carry out the activities as described in the protocol (below). You can NOT fill out the form on the Web. Please review the information. If you have further questions, please call 319.335.8392 and ask to speak to the Nurse Manager about the Blood and Body Fluid Exposure Protocol.

Flowcharts

• Medical student at UIHC
• Nursing student at UIHC
• Physician Assistant student at UIHC
• All health science students at off-site locations
• All UI students

Protocol for students who are exposed to blood or body fluids while enrolled at the University of Iowa

Purpose

The purpose of this policy is to delineate a clear mechanism by which all University of Iowa students can receive immediate evaluation, testing, initiation of necessary prophylaxis, and follow-up for exposures to blood and body fluids. This includes any exposure to blood/body fluids that may occur in such locations as residence halls, classrooms, and health care settings.

These recommendations were not developed to address sexual exposures. Certain sexual exposures may warrant individual consideration of this protocol.

Policy

The University of Iowa Student Health Services will provide initial screening, evaluation, testing, and initiation of necessary prophylaxis, follow-up, and referral when indicated for students who have had an exposure to blood or body fluids. In this process, Student Health Services will rely on the student's supervisor for information on the source; will consult with other caregivers when the student chooses or is located off-campus; and will consult with the Division of Infectious Diseases (Internal Medicine) as needed and for annual program review.

Definition

Possible blood borne pathogen exposure: Any student having exposure to blood or other body fluid should contact Student Health Services as soon as possible. Possible exposure to a blood borne pathogen will include: injury by a contaminated needle (e.g., non-sterile, used needle), any contaminated sharps injury, exposure to an individual's blood or body fluids to non-intact skin, eye, nose, or mouth, or though a human bite that breaks the skin.

Procedure

Student will:

• Immediately wash/irrigate area thoroughly.
• identify source (patient).
• inform supervisor or other responsible person in unit/agency.
• telephone Student Health Service (SHS) Nurse (319) 335-8392 - for screening and advice. If SHS is closed, telephone UIHC-ETC - (319) 356-2233, and ask to speak to the ETC Triage Nurse/Staff Physician.
• complete the agency's Incident Report and, if applicable, the State of Iowa Employers Work Injury report.
• report to Student Health Service or other provider off-campus as advised by SHS Nurse.
• report to VA Medical Center Employee Health for immediate workup if exposure occurs at VA.

Complete Follow-up

• if off-campus, send completed forms and completed treatment records back to SHS within one week, or as soon as possible.
• accept responsibility for follow-up needs of incident.

Student Health Service will:

• see student on priority basis.
• initiate additional wound care as needed.
• provide care and treatment whenever necessary according to policy as modified from UIHC Infection Control Policy 501 Protocol for Evaluation and Treatment of Hospital Staff Members Potentially Exposed to BloodBorne Pathogens and in consultation with Division of Infectious Diseases.
• make appointments for all follow-up visits prior to the student leaving the clinic.
• complete and file forms as required.
• provide student with education regarding need for follow-up visits for counseling and testing, how to avoid future exposures, symptoms of possible infection, safer sex practices.
• review program yearly with Division of Infectious Diseases.

Student Health Service Nurse or Physician/ETC will:

• evaluate incident to determine level of risk and referral level need.
• communicate with student and supervisor as necessary regarding immediate care, referral and follow-up needs.
• fax essential form(s) to student if student is off-campus or does not have forms.

Student's Supervisor/Attending M.D./Preceptor will:

• provide release time for student as necessary.
• investigate source person.
• if attending MD refuses to test source patient, Student Health Service medical staff will telephone on-call Epidemiology physician to request assistance.
• communicate information on source person to Student Health Service nurse.
• if off-campus, identify local treatment center to provide initial work-up and follow-up care following Student Health Service protocol.

If seen at ETC, ETC will:

• follow the same protocol for immediate evaluation and care as used by Student Health Service.
• access student immunization history through INFORMM.
• send report to SHS BBPE Coordinator in the morning of the next SHS clinic day.
• transfer the student to Student Health Service for follow-up care.

For students receiving training at College of Dentistry (COD):

• exposed individual's evaluation to be done at the Student Health Service.
• source patient's blood sample to be drawn at COD and sent to Student Health Service with exposed student.

Page last updated: 3/27/08