Student Safety

Hepatitis B Virus (HBV) and Human Immunodeficiency Virus (HIV) Education and Management

1. Prior to any exposure to clients/patients and as a prerequisite to clinical preparation, students will receive instruction on universal precautions for blood and body borne infections in accordance with applicable Centers for Disease Control (CDC) guidelines. Information regarding personal health habits, HBV and HIV prevention, and risk behaviors will be given. Exposure control education will be provided in the first quarter courses, and will be continually reinforced. Documentation indicating that each student has been provided this information will be kept on file with the departmental office.
2. All healthcare personnel are ethically and professionally obligated to provide client/patient care with compassion and respect for human dignity. No healthcare personnel may ethically refuse to treat a patient solely because the patient is at risk of contracting, or has, an infectious disease such as HIV, AIDS, or HBV. Students and faculty must understand and follow rules of confidentiality as stated under Patient Rights, as well as all applicable laws and regulations.
3. Clinical supervision is managed to ensure strict compliance in all clinical learning experiences.

1. Students who are HBV or HIV positive, or who have AIDS, must follow the CDC guidelines and universal precautions.
2. Students who know they are infected are encouraged to voluntarily inform their Campus Dean/Director of Nursing or designee. The Campus Dean/Director of Nursing or designee will begin a process to assess the need for necessary modifications/accommodations in a clinical education or job function.
3. Clinical and laboratory settings that pose additional risk to the personal health of HIV positive students and faculty should be identified. Such persons should be advised of these risks and urged to consult their health care provider to assess the significance of the risks to their own health.
4. Any modification of clinical/lab activity of HBV positive or HIV positive students will take into account the nature of the clinical/lab activity, the technical expertise of the infected person, the risks posed by HBV or HIV carriage, functional disabilities, and the transmissibility of simultaneously carried infectious agents.

Students have ethical responsibilities to know their HBV and HIV status and have an obligation to be tested if they believe they may be at risk for HBV or HIV antibody. While the testing decision should be voluntary for the individual, there may be instances in which testing could be required. Students may choose where to receive testing. The College supports the principle of confidentiality and individual rights in conjunction with the CDC guidelines on exposure to blood-borne disease.

In accordance with College and clinical agency policies, all students are required to present documentation of a completed series of HBV immunizations prior to attending clinical. If the student declines to complete the series due to health, religious, or other reasons, a declination form must be signed.

Universal precautions will be followed at all times. This method of infection control requires the student to assume that all human blood and specified human body fluids are infectious for HBV, HIV, and other bloodborne pathogens. Where differentiation of types of body fluids is difficult or impossible, all body fluids are to be considered as potentially infectious.

The use of personal protective equipment, appropriate engineering controls, and proper work practices must be continually reinforced among faculty and students to prevent exposure incidents to blood or other potentially infectious materials (OPIM). However, if an incident occurs, faculty and students should report the incident as soon as possible and be fully familiar with the procedures for testing, evaluation, and treatment.

A potential exposure incident can include:

1. Percutaneous inoculation: needle sticks or sharps
2. Non-needle percutaneous injury: open cuts or abrasions
3. Direct mucous membrane contact: accidental splash
4. Non-intact skin contact with blood or OPIM

1. Immediately apply first aid as appropriate
2. Allow to bleed freely (for needle stick/puncture injury)
3. Wash thoroughly with soap and water
4. Mucous membrane: flush copiously with water
5. Eyes: Irrigate and/or flush copiously with water
6. Document the incident, including:
   • Route of exposure
   • How and when exposure occurred
   • The source individual, if known
7. Report exposure immediately to nursing or science faculty and appropriate supervisor on campus or at the clinical agency.

In the event a student receives a needle puncture injury or other parenteral contact, the guidelines of the affiliating agency shall be followed. It is the injured/exposed student’s responsibility to report and follow the criteria established by the facility to report the incident to the instructor, and to address any expenses incurred. The College will not accept responsibility for expenses incurred.

1. Student and instructor should determine immediately if the incident involved a clean or used needle.
2. Any student on clinical rotation who has a needle puncture shall be sent to his/her physician or other health care agency. Protocols of the facility will be followed.
3. Injuries sustained with needles that have not been used on patients or their blood products require careful cleansing. Ice should be applied to the wound if needle contained a vesicant chemotherapeutic agent. Tetanus prophylaxis should be individualized.
4. If a student reports a potential exposure incident to blood or OPIM, the following CDC guidelines are to be followed.
   • A student should be tested for HIV to establish zero negativity first, followed by a retest at 6 weeks, 3 months, 6 months, and one year. Students are financially responsible for any cost incurred with testing or treatment.
   • A blood borne exposure form should be completed and taken to the health care provider for appropriate testing and possible treatment. A copy will be kept in a confidential file. If the student elects not to follow the guidelines, she or he must sign the declination statement.

Information obtained from http://www.cdc.gov.