Response to and Accommodations for Exposure to Infectious Agents Policy

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IUSM-PO-EDU-SAF-0011

Full Policy Contents

Scope
Policy Statement
Reason for Policy
Procedures
Sanctions

ADDITIONAL DETAILS
Additional Contacts
Forms
Related Information
History

Effective: Immediately
Last Updated: 03/06/2017

Responsible University Office:
Medical Student Education

Responsible University Administrator
Office of Academic Records and Promotion

Policy Contact:
dreeser@iu.edu

RESPONSIBLE Associate dean for statewide system advancement
ACCOUNTABLE Senior associate dean for medical student education
SUPPORT Assistant dean for academic records and promotion
CONSULT General counsel
Educational Policy Subcommittee
Campus Health
INFORM Educational Policy Subcommittee
Learning technology, Medical Student Education

LCME Standards

12.8 Student Exposure Policies / Procedures


Scope

This policy affects medical students participating in clinical care.


Policy Statement

Any student who experiences an exposure has access to timely evaluation and care across all clinical sites.

Students with a communicable disease have a responsibility to continue universal precaution procedures. They also have an obligation to adhere to individualized recommendations to prevent the spread of disease and to protect patients, peers, and others.

Students who test positive for an infectious disease after an exposure will be supported by IUSM through standardized procedures with the intention of maximizing potential for return to safe patient care.


Reason for Policy

IUSM has a responsibility to students, the profession of medicine, and the community to support optimal post-exposure care and to support providers who test positive for a communicable disease. This policy aims to inform students of the proper procedures to follow after such an exposure.


Approval

Approved by the Curriculum Council Steering Committee 02/21/2017.


Procedures

The following protocol, as described in the universal precautions section of the IUSM Student Handbook, must be followed by students who have been exposed to body fluids that may be contaminated.

Students must be aware of the recommendations outlined in the relevant teaching hospital’s policies. Certain situations require a mandatory visit or telephone consultation with IUPUI Campus Health. Such situations include the following:

  • Needlesticks or other contaminated injuries.
  • Exposure to active cases of tuberculosis.
  • Mucous membrane exposure to bloodborne pathogens.
  • Exposure to varicella.
  • Exposure to active enteral infection with salmonella or shigella.

A formal process, assisted by the staff of Medical Student Education, allows IUSM students to request time away or a leave of absence when health or life circumstances require it. Students should refer to the Schedule Conflicts and Time Away and Leave of Absence Policies. Students also may apply for accommodations through the Disabilities Accommodations Committee at IUSM for any disability acquired from these exposures.

In the case where exposure leads to a positive diagnosis (e.g., HIV, hepatitis B, or hepatitis C), an expert review panel consisting of a physician familiar with the trainee (typically the director of the IUPUI Campus Health Center), an infectious disease physician, a university attorney, and an administrator in the school is formed. Following the Society for Healthcare Epidemiology of America guidelines for management of health care workers who are infected, the review panel discusses the case and decides if the trainee can continue in the program (typically yes) and if there are to be any restrictions (depends on what the program involves).

A nurse or physician at IUPUI Campus Health is available 24 hours a day on pager 317-312-OUCH (312-6824) to provide information regarding needlesticks and other exposure injuries. Students who sustain a needlestick or other exposure should page the OUCH pager immediately. Students exposed to or who are exhibiting signs and symptoms of contagious diseases, including but not limited to varicella and viral conjunctivitis, should go to a health services location to be seen as soon as possible. If the situation occurs when the health service locations are closed, the student should page the OUCH pager.

IUSM has established guidelines for the management of communicable diseases in its students. Individuals whose behavior, for any reason, significantly deviates from guidelines at the practice site, thereby placing patients, staff, or colleagues at risk of exposure to communicable infection, may be suspended from participation in the school curriculum pending prompt review by the dean.

The exposure policy allows for serologic testing for all students who wish to know their HIV antibody status. Testing will be done confidentially and results will be reported only to the individual tested and to any agency required by state and local health codes. This testing is done at the student's expense.

The IUSM central policy described is augmented by some local processes at the regional campuses:

IUSM-Bloomington: Students receive notification of policies for the school and for IU Health Bloomington Hospital at the orientation for each new academic year, whether online or lecture. Students also receive fit testing annually. Third-year students are instructed to contact IU Health Bloomington Hospital infection control and employee health in the event of an exposure. Students are provided an information card with contact information and directions on management of an infectious exposure.

IUSM-Evansville: A student who has been exposed is directed by his/her laminated card to contact the regional hospitals or outpatient facility where the event occurred. The student also notifies the local campus at 812-492-7505 and IUPUI Campus Health at 317-312-OUCH (6824), available 24 hours a day.

IUSM-Fort Wayne: In case of exposure or injury, the student should:

  • Contact Employee Health Services and the nursing supervisor of the hospital immediately.
  • If EHS is not available, the student can call/report to the nursing supervisor of the hospital.
  • The hospital will be responsible for identifying and/or evaluating the source patient.
  • The student should follow up with his/her own physician.

IUSM-Muncie: Students should follow this procedure if a needlestick occurs:

  • Call IU Health Ball Memorial Hospital paging operator at 765-747-3298.
  • Ask the paging operator to page the Infectious Disease Department.
  • The Infectious Disease Department will advise on a course of action.

IUSM-Northwest-Gary: If a student is exposed, he/she is expected to report to the employee health department or, after hours, the emergency room. The student should contact the nursing supervisor and identify him/herself as a medical student. The student also must notify IUSM-Northwest-Gary when an exposure occurs.

IUSM-South Bend: A student who has been exposed should refer to the laminated card, which provides contact information for five regional hospitals as well as the procedure for an outpatient facility. The student also must notify the school at 574-631-5574.

IUSM-Terre Haute: A student who has been exposed should:

  • Report the incident immediately to the charge nurse at the present location. The charge nurse will supervise the testing of the source patient.
  • Proceed to the emergency room for medical treatment, if necessary.
  • Report the incident to the campus clinical clerkship coordinator and IUPUI Campus Health.

IUSM-West Lafayette: The laminated card has contact information for two local hospitals, as well as the outpatient facility. Students also are to notify IUSM-West Lafayette at 765-496-7973.

Students may request that the review panel reconsider its recommendations. A written request must be submitted to the review panel within seven working days of the panel’s decision. The panel may affirm its prior decision and/or recommendations or modify them. Before notifying the student of its decision, the panel will forward its proposed decision to the dean of the medical school for approval and/or modifications. The panel will provide to the student in writing the decision on the reconsideration request, including any modification in its decision and/or recommendations.

Any decision of the review panel or any other decision made pursuant to this policy may be appealed to the dean of the medical school. The appeal must be submitted in writing within 10 working days of the date of the decision. The dean’s decision is final.


Additional Contacts

Subject Contact Phone Email
Assistant dean for medical student education Antwione Haywood (317) 278-2891 haywooda@iu.edu
Deputy general counsel Joseph Scodro, J.D. (317) 274-5277 jscodro@iu.edu
IUSM Website Andy Foster fosteran@iu.edu

Forms

Indiana University School of Medicine

Infectious Disease Exposure Information for MD Students (Front-Laminated Card)

______________________________________________________________________________________


IUSM ensures that IUSM MD students exposed to infectious diseases in the course of their training receive appropriate care. Such diseases include, but are not limited to HIV, Hepatitis B, Hepatitis C and tuberculosis. Follow the instructions on the back to access services if you experience an exposure.

Hospital Infection Control Departments may provide additional assistance regarding contagious diseases. Do not hesitate to contact the Infection Control Department at your hospital should you have an exposure.

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Indiana University School of Medicine

Infectious Disease Exposure Information for MD Students (Black- Laminated Card)

______________________________________________________________________________

What to do if………

  1. You have a contaminated injury (needlestick or splash with blood or body fluid)
  1. Follow the instructions for your regional campus
  2. If you wish to discuss your case with IUPUI Campus Health, feel free to do so.  You can page 317-312-OUCH (312-6824) anytime.
  3. Follow the instructions given for your regional campus
  4. If you wish to discuss your case with IUPUI Campus Health, feel free to do so.  You can page 317-312-OUCH (312-6824) anytime.
  1. If you have a potentially contagious disease (i.e. chickenpox, pertussis, etc)

Related Information

Course Absence Policy.
Clerkship Absence Policy.
Exam Rescheduling Policy.
Disabilities Accommodations Policy.
Universal Precautions Policy.
Infectious Agents’ Policy.


History

Formerly called the Needlestick Policy.
Initial version of IUSM-PO-EDU-SAF-0011 01/17/2017.
Approved by the Curriculum Council Steering Committee 02/21/2017.

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