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UVa School of Medicine

 

Clerkship - Student Health Policy

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Occupational Exposure Policy


Needlestick (at UVa): PIC 1523 for On Call Bloodborne Pathogen Exposure (blood-body fluid exposure procedure)

Services covered by student fees/tuition:

1. Student Health will provide testing and immunization services for medical students who are at risk of or experience an occupational exposure while working as a trainee in a clinical setting. Coverage does not extend to prophylactic or therapeutic Tamiful.

2. All medical students are eligible to receive influenza vaccines as well as annual PPD testing at Student Health. In addition, in the event of a needlestick or blood/body fluid exposure or acute exposure to tuberculosis during clinical training, students are provided at no additional cost all diagnostic evaluations, hepatitis immune globulins, and HIV post-exposure prophylactic medications when ordered or coordinated by a Student Health provider (see below).

Services not covered:

1. Long-term medications, diagnostic evaluations, or treatments (over one month's duration) will be the responsibility of the student (or student's health insurance).

2. Fees related to the emergency room or hospitalization will be filed with the student's health insurance carrier.

3. Hospitalization will be the responsibility of the student (or student's health insurance).

Students not paying full fees:

1. Students not paying full fees are not covered under this policy and therefore will be personally responsible for all diagnostic tests, immunizations, and treatments.

Procedure

Immunization and tuberculosis screening:

Any medical students requiring influenza immunizations or PPD screening may schedule an appointment with Student Health during regular operating hours (PPD required annually).

Procedure for blood/body fluid exposure:

For rotations at UVa:

1. Report the incident to the faculty supervising the clinical service. All exposures should be reported immediately to the person on call for Bloodborne Pathogen Exposures by paging (pic #1523) to report the exposure. This pager will be covered by employee health except during off hours, in which case the nursing supervisor covers this pager. The person covering this pager will initiate the triage process and contact individuals involved in the process.

2. If a medical student has been exposed to a patient’s blood or body fluids in a manner that may transmit HIV or hepatitis B or C, the Medical Center will test the source patient’s blood for HIV and hepatitis B and C. The source patient’s treating physician or designee will order the source patient’s tests and provide or arrange for any necessary treatment. Employee Health will order the exposed healthcare workers tests and provide all necessary prophylactic treatment except during off hours, in which case the Emergency Department will do the same.

For away rotations:

1. Report the incident to the faculty supervising the clinical service. For hospital rotations, follow the procedure for that facility.

2. Page the Dean on Call (924-0000, pic 1416) for instructions. The decision will be made at that time whether to seek care locally or return to the University.

3. If a medical student has been exposed to a patient’s blood or body fluids in a manner that may transmit HIV or hepatitis B or C, the source patient’s treating physician or designee will order the source patient’s testing.

For all students:

All students who have been evaluated and or treated for exposure to blood and body fluids will be referred to the Student Health Center for follow-up. The student will be advised to call Student Health (434-982-3915) to be seen 48 Hours after exposure. All paperwork and laboratory reports will be faxed from Employee Health prior to this visit. The Student Health triage physician will review the needlestick and blood and body fluid report forms at the 48 hour visit follow-up visit after the exposure Post test counseling will be provided at this time. An appointment schedule will be developed with the assistance of the triage nurse for 6 weeks, 3 month and 12 month visits. The “Agreement for follow-up of Needlestick/Blood or Body Fluid Exposure” form will be completed by the triage nurse, and the student asked to sign it. The student signature indicates their understanding of the recommendation to comply with the schedule, especially if graduation occurs before the final 12 month assessment. Policies and procedures related to exposure to infectious agents are available through Student Health and are based on CDC and OSHA guidelines.

Billing

All costs for testing, immunization, diagnostics, and prophylactic medications as a result of occupational exposure will be covered by fees for the first month (insurance will be billed thereafter). Students who sustain exposures on away rotations should have billing fees charged to their personal insurance policies, and whatever is not covered will be billed to the School of Medicine via Student Health.