Infection Control Guidelines, Immunization Requirements & Exposure (Incident Reporting) Policy
While transmission of infectious diseases by pharmacists usually does not happen often, the increased role pharmacists are taking in patient care will increase the chances for exposure and transmission of diseases. Therefore, precautions are extremely important to protect both patients being cared for and health professionals providing care. Students are taught aseptic technique in preparing intravenous products. However, any physical assessment or contact (in addition to venipuncture or finger sticks) with patients can potentially transmit disease. All health care professionals must use proper universal precautions and immunization guidelines.
During PharmD experiential training, students will be involved in direct patient care and therefore at risk for potential exposure to infectious materials and patients. Prior to registration, students must provide proof of the following-immunizations/immunity:
- Tetanus-diphtheria-pertussis: Td booster within the past 10 years: Must have a one-time dose of Tdap or Td booster, unless contraindicated.
- Polio:Complete IPV or OPV series
- MMR:MMR: Two doses or laboratory evidence of immunity to each of the three diseases
- Hepatitis A:Two-vaccination series required before the end of the first professional year, students must provide documentation of the second dose.
- Hepatitis B:Students must show documentation of a three-dose series of the first of the three doses upon admission to the College of Pharmacy & Health Sciences. Before the end of the first professional year, students must provide documentation of the second and third doses in a series.
- Varicella (chicken pox): Students must either receive the two-series Varicella vaccination or prove immunity to the Varicella virus by a positive (+) blood titer. History of “chicken pox” in your medical is NOT sufficient.
- Tuberculin (PPD) skin test: Annually (some rotations sites require a 2-step PPD - the College of Pharmacy & Health Sciences will let the student know if this applies.) If the TB skin test is positive a chest X-ray is required.
- Influenza:Annual flu vaccine is required.
The Center of Disease Control (CDC) has developed precautions to prevent accidental spread of infectious diseases to both students and patients. These include:
Hand washing (or using an antiseptic hand rub)
- After touching blood, body fluids, secretions, excretions and contaminated items
- Immediately after removing gloves
- Between patient contract
- For contact with blood, body fluids, secretions and contaminated items
- For contact with mucous membranes and non-intact skin
Masks, goggles, face masks
- Protect mucous membranes of eyes, nose and mouth when contact with blood and body fluids is likely
- Protect skin from blood or body fluid contact
- Prevent soiling of clothing during procedures that may involve contact with blood or body fluids
- Handle soiled linen to prevent touching skin or mucous membranes
- Do not pre-rinse soiled lindens in patient care areas
Patient care equipment
- Handle soiled equipment in a manner to prevent contact with skin or mucous membranes and to prevent contamination of clothing or the environment
- Clean reusable equipment prior to reuse
- Routinely care, clean and disinfect equipment and furnishings in patient care areas
- Avoid recapping used needles- use self- capping safety needles if available
- Avoid removing used needles from disposable syringes
- Avoid bending, breaking or manipulating used needles by hand
- Place used sharps in puncture-resistant containers
- Use mouthpieces, resuscitation bags or other ventilation devise to avoid mouth to mouth resuscitation
- Place patients who contaminate the environment or cannot maintain appropriate hygiene in private rooms
OSHA Bloodborne Pathogens Training
The CPHS requires that all students have contact with patients view the OSHA Bloodborne Pathogens (BBP) training video. Copies of student training records will be kept in the student’s record in the office of each respective professional program.
Students presenting with signs or symptoms of infectious or communicable diseases have a duty not to spread illness to others. Students should consult Student Health Services (910) 893-1516, their preceptor, clinical supervisor or the infection control office at the clinical site about the advisability of working with patients and when it is safe to return to patient care.
Body Fluid & Needle Stick Policy & Procedure
Incidents involving needle sticks and exposure to body fluids or potential bloodborne pathogens require immediate action to protect a student’s health and safety. If a student sustains a needle stick or is exposed to infectious materials s/he should:
1. Immediately wash exposure site thoroughly with soap and water (or water only for mucous membranes)
a. Wash needle stick and cuts with soap and water
b. Flush the nose, mouth or skin with water
c. Irrigate eyes with clean water, saline or sterile irrigants
2. Notify the preceptor/clinical supervisor at the rotation site for assistance
a. For pharmacy students the preceptor should notify the Office of Experiential Education (800) 760-9697 (Jean White x1709/email: email@example.com or Penny Shelton x1716/ email: firstname.lastname@example.org) as soon as reasonably possible to begin the process of filing an incident report.
3. Seek Immediate care for necessary lab work and post-exposure prophylaxis
a. In the event that the rotation site has an existing exposure policy, the student should comply with the site’s policy
b. If the rotation site is not able to assist the student, the student should seek care the nearest available facility to provide appropriate care (initial lab work for HIV, HBV,HCV and risk assessment to determine the need for chemoprophylaxis, etc.) or students can be seen at Campbell University Student Health Service.
4. The preceptor or appropriate institutional representative should obtain consent from the source patient for appropriate laboratory testing (i.e. HIV, HBV, and HCV status).
a. Students should receive post-exposure prophylaxis within hours of the exposure rather than days, per CDC recommendations, if the status of the source patient is deemed high risk or if there is uncertainty of the source patient’s status.
5. Some clinical sites will provide post-exposure care to students at no charge. When this is not the case, needle sticks, and other exposure are covered under the Campbell University Student Accident Insurance Policy. Accidental infectious exposure MUST be reported as directed in this policy
a. The accident policy is underwritten by Guarantee Trust Life Insurance Company and administered by First Agency, Inc.
I. First Agency, Inc. 5071 West H Avenue, Kalamazoo, MI 49009-8501 Phone: (269) 381-6630 Fax: (269) 381-3055 Web: www1stagency.com
II. Policy #: 324-125-001-O
b. When presenting to a clinic for post-exposure care, the student may provide the above policy information and his/her student ID card. However, the site may or may not accept direct payment through this plan. Students may have to pay out of pocket at the time of service. However, reimbursement for services up to $5000 per incident can be filed via student health services. Students will need:
i. To provide an itemized statement complete with diagnosis and procedure codes; AND
ii. Complete a claim form either in person, or call Student Health (910) 893-1560. The staff will be glad to help you fill out the form by email correspondence.
iii. Student Health personnel will provide further instruction on how to complete and file your claim
iv. If requested, mail documents to : Campbell University Student Health, PO Box 565, Buies Creek, NC 27506;
c. Students may opt to use their personal health insurance to cover the cost of post-exposure care in lieu of using the Campbell University Student Accident Policy.
6. Although, the preceptor or clinical supervisor may have contacted CPHS as indicated above, the student must also contact Pharmacy Office of Experiential Education as soon as reasonably possible but within a minimum of 72 hours of the exposure to finalize the incident report.
a. The incident report shall contain:
- The date and time of exposure
- Clinical Site, location and unit information
- Details of how the exposure occurred
- Details of the type and severity of the exposure
- Details about the source patient (i.e. post-exposure management, previous vaccinations, current HIV, HBV, HCV status)
b. The Office Experiential Education will provide a copy of the incident report to Student Health Services. This will alert the Student Health office in the event that an accident insurance claim needs to be filed.
c. In the event that an incident report was filed at the rotation site, a copy of this must be sent the Pharmacy Office of Experiential Education to be maintained in the student’s file.
7. In the event of an exposure, The National Clinician’s Post Exposure Prophylaxis Hotline (888) 448-4911 is available 24 hours per day, 7 days per week to provide guidance in managing exposures.