I. PURPOSE
The purpose of this policy is to ensure medical students receive education regarding prevention of exposure to infectious and environmental hazards.
II. POLICY
It is the policy of New York Medical College SOM to provide structured education regarding the methods of prevention of exposure to infectious and environmental hazards, and education regarding the procedures to follow in the event of exposure. All procedures following exposure to communicable disease are in accordance with New York State Department of Health regulations.
III. SCOPE
This policy applies to all medical students.
IV. DEFINITIONS
A. Barrier precautions: personal protective equipment used to prevent transmission of infectious agents. These include gloves, gowns, face masks, N95 respirators, and eye protection.
B. Blood or body fluid exposure: a percutaneous injury, or exposure of a mucous membrane, to blood or body fluids that are potentially infectious for HIV-1, Hepatitis B or Hepatitis C virus.
V. PROCEDURES
A. Education to prevent exposure to infectious and environmental hazards:
1. SOM Year 1 students are required to complete the New York State Department of Health Infection Control and Barrier Precautions Certification course. This course provides students with a four-year Infection Control certification which is also required for all licensed health care professionals in New York State. The Office of Student Affairs monitors compliance with the completion of this course.
2. Education regarding hand hygiene, the use of personal protection equipment (gloves, gowns, eye protection, masks and respirators), procedures for disinfection, and specific infection control procedures occurs annually for the first three years of the SOM curriculum.
a. During the first year, hand hygiene and donning and doffing of face masks with direct observation of performance, must be completed before interaction with standardized patients.
b. During the second year, review of donning and doffing of all personal protective equipment, a review of hand hygiene, and procedures to follow in the event of a blood or body fluid exposure occurs before any direct patient care activity with a preceptor.
c. During the Transition to Clerkship course, a 2-hour mandatory lecture is provided to students entitled: Infection Control Essentials. The lecture covers in detail Standard Precautions, Transmission based Precautions (airborne, droplet and contact), precautions needed for communicable diseases, efficacy of hand hygiene, and specific procedures if one sustains a needlestick or a blood and body fluid exposure. Students are provided with a laminated cardstock card entitled “Procedures for blood and body fluid exposures and other exposures” for reference during clinical clerkships. Students are also informed that they must present their health insurance card when evaluated by the Emergency Department for a blood or body fluid exposure. Students are not hospital employees and thus these services are billed to insurance.
d. During Transition to Clerkship, students must meet one-on-one with a clinical member of NYMC Health Services for fit testing for N95 respirators and to review their status of immunity to communicable diseases and required tests for clerkship.
e. Education and performance of a surgical scrub: Students are given education and directly observed performing a surgical scrub before and clinical activity involving access to a surgical suite.
B. Procedures following blood or body fluid exposure or exposure to a communicable disease are described in the Procedure for Needlestick, Blood/Body Fluid Exposures.
1. Clerkship directors at each site are to ensure that students are informed of where to report to in the event of blood or body fluid exposure.
2. Students are to also report the blood and body fluid exposure to NYMC Health Services. Health Services is responsible for all the follow-up testing of the student and any follow-up prescriptions that may be needed for post-exposure prophylaxis.
3. For exposures to communicable diseases, students are to follow the recommendations of the Infection Control Department of the hospital and/or the Department of Health and report the exposure to Health Services. Health Services will assist in the coordination of prophylaxis if indicated or surveillance and or follow up testing.
4. In accordance with New York State Department of Health regulations, students who are potentially incubating a communicable disease due to exposure may be required to be furloughed from in person activity. See COVID-19 Student Protocol For Exposure Confirmed or Suspect Infection.
VI. EFFECTIVE DATE
This policy is effective immediately.
VII. POLICY MANAGEMENT
Executive Stakeholder: Director, Health Services
Oversight Office: NYMC Health Services
VIII. REFERENCES
LCME Element 12.8: Student Exposure Policies/Procedures: A medical school has policies in place that effectively address medical student exposure to infectious and environmental hazards, including the following: • The education of medical students about methods of prevention • The procedures for care and treatment after exposure, including a definition of financial responsibility • The effects of infectious and environmental disease or disability on medical student learning activities All registered medical students (including visiting students) are informed of these policies before undertaking any educational activities that would place them at risk.
RELATED POLICIES:
COVID-19 Student Protocol For Exposure Confirmed or Suspect Infection
Policy on Blood and Body Fluid Exposures (Needlestick)
