Introduction
During the performance of clinical practice or research activities, students may have contact with patients or research participants with infectious diseases. This contact may place the student at risk for exposure to an infectious agent and/or may result in an infectious disease being transmitted to others. This policy has been established to address The Ohio State University, College of Nursing’s concern for protecting students and clients from the risk of infectious diseases. The policy is in accordance with recommendations of the American Association of Colleges of Nursing (AACN) and recognizes individual rights, voluntary testing, and the confidentiality of test results of all involved. The document is organized in relation to: (1) Prevention, (2) Responsibilities of the student in the care of infected patients, and (3) Post-exposure safety measures.
Prevention
Students can be reasonably protected from the risk of contracting and transmitting an infectious disease in the course of nursing practice with appropriate education, skills training, and immunizations.
Standard and Transmission-based Precautions
Students will receive education on the Centers for Discase Control and Prevention (CDC) guidelines on standard precautions and transmission-based precautions prior to attending on-site clinicals. Following the CDC’s guidelines can help protect against acquiring and transmitting infection.
Students are expected to adhere to Standard Precaution guidelines and infection control practices as established by the CDC and the Occupational Safety and Health Administration (OSHA) to reduce the risk of contact, droplet and airborne transmission of pathogenic microorganisms.
Vaccinations and Testing
Mandatory Vaccination/Testing
Students must meet The Ohio State University College of Nursing compliance requirements prior to established timelines and cannot participate in clinical if not meeting compliance requirements.
[NOTE: Students who are pregnant or think they are pregnant should document the pregnancy in a written letter and submit the document to Wilce Student Health Services. Some health requirements may be waived for pregnant students or for individual students whose situations may warrant such action.]
Discretionary Vaccination/Testing
Responsibilities of the Student in the Care of Infected Patients
Nurses are front-line providers of health care, and the delivery of nursing care is not without safety hazards. Students who follow the recommendations developed by the Centers for Disease Control have minimal danger of contracting any infection in the course of their clinical practice/research activities.
Refusal to care for an infected patient is contrary to the ethics of the nursing profession. Students who express apprehension or concern over personal safety and health because of a clinical assignment that brings him/her in contact with individuals who are at risk for or who are infected with an infectious disease will be provided guidance by his/her clinical instructor and directed to specific information concerning the pathogenic organism and recommended precautions. Students who refuse to care for an infected individual because of the belief that it will place him/her at risk of exposure, when reasonable risk cannot be demonstrated (e.g., the student is not immunocompromised), will be advised that such action is not in accordance with satisfactory clinical performance. Such cases will be handled as individual instances in which students have not met the course requirements.
When caring for persons with infectious diseases, students and faculty are expected to follow current HIPAA rules of privacy and confidentiality.
POST -EXPOSURE SAFETY MEASURES
Management of Student Exposed to Pathogenic Microorganisms
Any incident that exposes a student or a patient to the risk of a pathogenic microorganism by needle puncture or contact with secretions/body fluids while in the clinical setting should be reported to the student’s clinical instructor and clinical nursing supervisor (preceptor and/or charge nurse) immediately. Specific agency/institution procedures for such contact should be followed. Immediate actions should include:
- Wash needle sticks and cuts with soap and water
- Flush splashes to the nose, mouth, or skin with water
- Irrigate eyes with clean water, saline, or sterile irrigants
- Immediately seek medical treatment
Treatment areas at the OSU Medical Center include: Employee Health (614-293-8146), Occupational Medicine (614-688-6492), or, after hours and on weekends and holidays, Emergency Department (614-293-8333). Any questions should be directed to the Ohio State University Environmental Health and Safety Office (614-292-1284). Students who are at agencies other than the OSUMC system should follow the guidelines according to the placement agency. Payment for any treatment is the responsibility of the student. The College of Nursing does not reimburse for the costs of blood tests, medical follow-up, and treatment. Students should submit invoices to their personal health insurance providers.
Management of Student who is a Source of Pathogenic Organism
Students who have been diagnosed with infectious diseases should understand that they may pose a risk to patients, particularly highly vulnerable populations like neonates, oncology patients and those immunocompromised from disease or treatment. Students have an ethical duty to be aware of their immunity status or chronic infectious disease (e.g., Hepatitis B, HIV) status to ensure they do not place others at risk of infection. Students who know they are infected are encouraged to voluntarily inform the Associate Dean for Academic Affairs in the college who will refer the students to the Office of Disability Services for modifications or accommodations in clinical education. Such modifications will be made on a case by case basis considering compliance with CDC recommendations and University policy.
References
American Nurses Association (2001). Code of Ethics for Nurses. Washington, D.C.: American Nurses Publishing. Web site: www.nursingworld.org/codeofethics
Centers for Disease Control (CDC) Web site: www.cdc.gov/niosh/topics/bbp/
United States Department of Health and Human Services. Office for Civil Rights. Web site: www.hhs.gov/ocr/hipaa/
Occupational Safety and Health Administration. Web site: https://www.osha.gov/SLTC/bloodbornepathogens/bloodborne_quickref.html
Ohio State University Environmental Health and Safety Office. Web site: http://ehs.osu.edu/
*Note: This policy is based on currently available information. It will be updated as new information is forthcoming from the Centers for Disease Control (CDC). In the absence of new CDC directives, the policy will be reviewed annually in accordance with the University Infection Control guidelines/requirements.
LAST REVIEW/REVISION DATE:
May 2021