Infection Control/Prevention and Exposure Response

Infection Control and Exposure Response

The safety of all students, staff, faculty, and patients is of primary concern. Therefore, during orientations for both didactic and clinical education phases, PA students are presented with information on personal security and fire safety, in addition to infection control, HIPAA, and OSHA. Furthermore, PA students will be required to complete any clinical site-specific safety or security training requirements in preparation for supervised clinical practice experiences. Students must be aware that risk exists for exposure to infection and environmental disease during the didactic and clinical phases of the Program. PA students, staff, and faculty must adhere to all established Emory & Henry College safety protocols.

  • Didactic-phase students must notify their course director and/or MLFC preceptor as soon as possible of any exposure to bodily fluids, chemical hazards, or potentially serious infectious diseases.
  • Clinical-phase students must notify their SCPE preceptor and the Director of Clinical Education as soon as possible of any exposure to bodily fluids, chemical hazards, or potentially serious infectious diseases.
  • All faculty, staff and students will utilize Standard Precautions (Methods of Prevention as outlined in the MPAS Program Student Handbooks) during all activities that present a risk of exposure to blood/body fluids or chemical hazards. Failure to do so will be grounds for disciplinary action.
  • Students must follow the exposure response plan detailed below in the case of any exposure to blood/body fluids, chemical hazards, or potentially serious infectious diseases.
  • Compliance with all safety practices is a not just good procedure, it is also a mark of your professionalism. Failure to observe and practice Standard Precautions may result in adverse/disciplinary action for unprofessional behavior and referral to the Student Progression Committee.

Methods of Prevention

Standard precautions (Methods of Prevention) are the minimum safety and infection prevention practices that apply to all patient care and laboratory or technical skills training experiences in any setting where healthcare or healthcare training is delivered. These practices are designed to protect healthcare professionals (HCP) and prevent HCP from spreading infections to others.

Methods of Prevention

Hand Hygiene

  • Good hand hygiene is critical to reduce the risk of spreading infection.

  • Current CDC guidelines recommend use of alcohol-based hand rub for hand hygiene except when hands are visibly soiled (e.g. dirt, blood, body fluids), or after caring for patients with known or suspected infectious diarrhea, in which cases soap and water should be used. Key situations where hand hygiene should be performed include:

    • Before touching a patient, even if gloves will be worn.

    • Before exiting the patient’s care area after touching the patient or the patient’s immediate environment.

    • After contact with blood, body fluids or excretions, or wound dressings.

    • Prior to performing an aseptic task (e.g. placing an IV, preparing an injection).

    • If hands will be moving from a contaminated-body site to a clean-body site during patient care.

    • After glove removal.

Use of personal protective equipment (PPE)

Exam gloves will be worn when there is risk of contact with or when handling blood or body fluids or when there is a potential for contact with mucous membranes, non-intact skin or body orifice areas, or contaminated equipment. Facial masks, protective eyewear and/or gowns (as well as gloves) will be worn when performing/assisting procedures with a risk of body fluid or other hazardous material splashes or sprays.

Safe injection practices:

  • No recapping of needles unless required by the specific procedure being performed.

  • Use of self-sheathing needles and/or needleless systems when available.

  • All needles and other disposable sharps will be placed in designated puncture resistant containers as soon as possible after their use.

Safe handling of potentially contaminated surfaces or equipment:

  • Environmental cleaning: Areas in which patient care activities are performed will be routinely cleaned and disinfected at the conclusion of the activity.

  • Medical equipment safety: Reusable medical equipment must be cleaned and disinfected (or sterilized) according to the manufacturer’s instructions. If the manufacturer does not provide guidelines for this process the device may not be suitable for multi-patient use.

Respiratory hygiene/Cough etiquette:

  • Cover mouth/nose when coughing or sneezing.

  • Use and dispose of tissues.

  • Perform hand hygiene after hands have been in contact with respiratory secretions.

  • Consider using a mask to prevent aerosol spread.

  • Sit as far away from others as possible.

Exposure Response

Wounds and skin sites that have been in contact with blood or body fluids should be washed with soap and water; mucous membranes should be flushed with water. There is no evidence that the use of antiseptics for wound care or expressing fluid by squeezing the wound further reduces the risk for HIV transmission. However, the use of antiseptics is not contraindicated. Use of caustic agents, e.g., bleach, is not recommended.

Incident/Injury Form

  • The student must notify her/his supervisor immediately and complete notice of incident forms in use by the clinical site as well as the Student Incident/Injury Form which is posted EValue.

Medical Evaluation: It is very important that medical evaluation take place immediately because treatment decisions must be made within 2 hours of exposure. HIV prophylaxis for high-risk exposure appears most effective if started within 2–4 hours. It is also extremely important to evaluate the donor’s risk status immediately.

  • The student should report IMMEDIATELY to his or her Clinical Preceptor and also contact the Director of Clinical Education within 24 hours of exposure.
  • If the exposure occurs at an off-campus clinical site, the student should follow the Infection Control policy of that facility. Outside of these hours, the student should go IMMEDIATELY to the nearest urgent care or emergency room.  
    • Note: If the incident occurs at a hospital or large medical facility, that facility’s Employee Health Clinic may be able to do the initial clinical evaluation.

Program Participation: Continued participation in the activities of the PA program will not be affected by any injury or illness that occurs while enrolled provided the student continues to meet all Technical Standards and fulfill all defined requirements for program progression and is not directly infectious by way of routine contact. Note: This only applies to serious, potentially life-threatening infections.

Financial Responsibility: Students are mandated to have health insurance throughout their participation in the Program. Students will be financially responsible for all costs incurred during compliance with this policy.

Laboratory Testing/Treatment: To determine whether treatment of the student is necessary, blood may need to be drawn from the patient (i.e. source of contamination) to evaluate Hepatitis B, C, and HIV status. In a hospital setting the Infection Control Nurse or Nurse Supervisor is often authorized to order these tests on the patient/donor. The Infection Control Nurse or Nurse Supervisor should also review the medical record, question the patient/donor about risk factors, and obtain the patient’s/donor’s consent to do the tests necessary to evaluate their health status. If the exposure occurs in an outpatient setting (and these tests cannot be done), the patient /donor may need to accompany the exposed student for evaluation.