Memo 45: Blood Borne Pathogens (BBP) Exposure/Clinical Incidents
We STRONGLY ADVISE that all nursing students have personal health insurance, or join a health care plan, to cover the expenses of their health care, treatments in case of an injury, and/or care for a catastrophic illness or serious chronic condition within or outside the clinical setting.
All nursing students are charged an annual baseline health fee. In addition to immunization tracking (see AS Memorandum 22), the student health fee also covers the after-insurance costs of initial care, baseline, and follow-up lab testing, and prophylactic medications given as an appropriate response for a reported episode of blood- or secretion-borne pathogens exposure (see below).
Policy on Infection Control Procedures for Health Care Providers Infected with HBV/HIV/HCV
In compliance with University of Washington Infection Control Procedures regarding blood-borne disease, the School of Nursing supports voluntary reporting of HIV/HBV/HCV status. As part of their professional responsibility and accountability, the School encourages all students to be aware of their risk status for HBV/HIV/HCV. If they are at risk for these diseases, they are encouraged to seek testing and to notify the School of Nursing of their status so as not to place patients in a position of risk. In addition to following standard precautions, it is recommended that students adhere to CDC guidelines, which state that students with a known blood-borne pathogen are expected to:
- Double-glove during all procedures involving the possibility of blood-borne exposure
- Refrain from all direct patient care and the handling of patient care equipment used in invasive procedures if the student has exudative lesions or weeping dermatitis
- Refrain from direct participation in exposure-prone procedures, which at the minimum include the following:
- Digital palpation of a needle tip in a body cavity
- Simultaneous presence of the student’s fingers and a needle or other sharp instrument or object in a poorly visualized or highly confined anatomic site
If an infected student must engage in such activities, each situation should be reviewed and specific practice protocol developed. All students are taught standard precautions as part of their basic nursing curriculum. Following these policies is essential for the protection of the care provider and the patient, and minimizes risk to either party.
Blood Borne Pathogens (BBP) Exposure
In order to minimize the risk posed to students and/or patients by persons infected with BBP as identified by the CDC and OSHA, all students without an RN license are required to complete BBP training as part of their program orientation.
Students exposed to blood- or secretion-borne pathogens (BBP) should take immediate first aid including scrubbing wounds and skin with soap and water for 20 minutes and/or flushing mucous membranes with water for 20 minutes.
Please refer to the link below to review the campus-wide-lab-testing-schedule: http://depts.washington.edu/chsweb/hsip-bloodborne-pathogen-exposure#App…
If a BBP exposure occurs in a clinical setting outside of UWMC/Harborview, refer to this testing schedule as a resource to avoid being charged unnecessary lab fees. Lab tests ordered must follow this schedule to qualify for reimbursement by the health fee.
Please note under baseline labs that it is unnecessary to draw Hepatitis B Surface Antigen (HbsAg) or Hepatitis B Core Antibody (HbcAB) titers if there is a documented history of completed Hepatitis B vaccine series and a positive Hepatitis B Surface Antibody. Health Sciences students who have already satisfied their initial program requirements by proving their immunity to Hepatitis B, in most cases, do not need to have these labs drawn after a bloodborne pathogen exposure.
Risk assessment and laboratory testing may be available to students at the clinical site’s employee health office. Need for medications for prophylaxis of BBP may require further assessment. If there is no employee health office at the clinical site or for exposures occurring after clinic hours, on weekends, or on holidays, students are to seek care at the nearest emergency room. Only the tests listed on the Approved Laboratory Testing Schedule for Reimbursement qualify for reimbursement from the UW Health Sciences Immunization Program.
The staff on duty in the Emergency Department (ED) at the University of Washington Medical Center (UWMC) is available at 206.598.4000 for information 24 hours a day.
Students experiencing an injury and/or BBP exposure at all clinical agencies complete, with the clinical instructor, the UW Nursing Student Clinical Incident/Injury Form. This form should be mailed to:
University of Washington School of Nursing
Attn: Patrick Tufford, Director of Student and Academic Services
Student and Academic Services
Seattle, WA 98195
Students, with their instructor, at Harborview Medical Center & UW Medical Center also need to complete a Patient Safety Net (PSN) report for any incident/accident reports.
UW Environmental Health & Safety
Hall Health Center
Seattle, WA, 98195
For BBP exposure, the Health Fee will cover the after-insurance costs of initial care, baseline, and follow-up lab testing, and prophylactic medications given as an appropriate response for a reported episode of BBP exposure. If a student has received emergency care after a BBP incident, the bill indicating the remaining cost after insurance has paid should be directed to: https://safetynet.medical.washington.edu/Datix/Live/index.php?action=newdif1&module=INC
Health Sciences Immunization Program
University of Washington
Seattle, WA, 98195-4410