Purpose:
To affirm the importance of student placement practices and to safely admit students and prevent unecessary exposure of current population.

Applicability:
Admitting, nursing, physician and staff working with that student.

General Statement:
A Free From Communicable Disease Form signed by an M.D., is requested for EVERY student prior to admission.
A. Since there are NO Isolation Rooms at HEC, any student found to have a communicable disease requiring isolation would be referred IMMEDIATELY to an appropriate facility by the School Physician.
B. Nursing assessments are done within 24 hours of Admission by an R.N.
C. Physicals are done within 30 days of an admission.

Controlling Infection

A. Admitting personnel will cooperate with nursing and the medical staff, when placing students who are immunosuppressed, at increased risk for infection, or suspected of/diagnosed with a communicable disease.
B. The physician will assess each student upon admission according to guidelines, and alert staff as to signs and symptoms, initial diagnosis, and type of precautions needed.
C. The ICC is to be notified AS SOON AS POSSIBLE of ANY student admitted who has a suspected or confirmed communicable disease.
D. Personnel potentially exposed to a student with tuberculosis, who was diagnosed after the admission process, will be .referred to Occupational Health.
E. If a student is admitted with a communicable disease such as: chicken pox, measles, etc., ALL personnel should be aware of their status. Staff members who have NO RECORD of having had the disease, report to the Charge Nurse. Other staff assignment may have to be made. ALL Pregnant staff, should be aware of communicable diseases they have had. This includes: Housekeeping, Dietary, etc. The ICC (or Designee) should be notified for evaluation.
F. If student currently in placement, develops a communicable disease that is deemed by the Medical Director not to require hospitalization or isolation, levels of bedrest will be initiated. See standing orders in Policies and Procedures for specifics on levels of bedrest. These levels provide for limited activity and decreased exposure to other students and staff as much as is possible in a residential setting.

Responsibilities

A. Training Coordinator

1. Document and maintain records of adequate education of ALL personnel, in infection control practice.
2. Assure compliance with Infection Control Polices and Procedures.
3. Assure compliance with Employee Health Program Policies.
4. Review and revise, as necessary, the Infection Control Policies and Procedures.
5. Submit ALL Policies and Procedures that may relate to infection control to the ICC for review, prior to adoption.
6. Report potential infection control hazards to the ICC and EOC Committee.
7. Make available to ALL Department personnel, ICC Policies, Procedures, and if applicable, Surveillance.

B. Infection Control Coordinator:

1. Available as a resource
2. Prepare, review and revise, Infection Control Policies and Procedures
3. Assist in preparing and presenting relevant educational infection control programs.
4. Periodically observe Departmental adherence to infection control practices.
5. Conduct additional investigations, as necessary.
6. Provide any surveillance or investigation data to Departments as indicated, by the EOC Committee.
 
C. EOC / IOP Committees

1. Review ALL Infection Control Policies.
2. Available as a Consultant.
3. Review ANY data and make recommendations concerning Departmental infection control practices.

Personnel:

A. UNIVERSAL PRECAUTIONS will be used by ALL personnel.
B. ALL staff will be screened for communicable diseases as stated in: Hillcrest Employee Health Policy.
C. ALL staff will participate in education programs at the time of hire, (BEFORE beginning job duties), and at least annually thereafter to review practices related to the prevention of infection.

MRSA:
Management of Community-Associated Staphylococcus Aureus (CA-MRSA) Infections

Purpose: To prevent the spread of MRSA infection from person to person ensuring the health and well-being of all students and staff.
Background: MRSA infections are skin infections that appear as pustules or boils which often are red, swollen, painful or have pus or other drainage. MRSA is typically transmitted by DIRECT skin to skin contact OR contact with shared items or surfaces (e.g. used towels, bandages, shared sports equipment, etc.). It is estimated that 30-50% of the population are carriers of the staphylococcus bacteria on his/her skin or in the nose passages and it can be easily transmitted from one person to another. According to the Centers for Disease Control and Prevention, almost all MRSA infections can be successfully treated with or without antibiotics.
Prevention is the best defense and students and staff should be reminded about the importance of simple hand washing and practicing good personal hygiene overall. All cuts and open draining wounds MUST be covered with a secure bandage.
Actions when a student is infected with MRSA:
1) Staff should notify nursing if a student has any signs of infected skin. (Pustule, redness, swelling, drainage)
2) Nursing staff will assess and treat the area. Cultures of any drainage will be obtained and sent to the lab. Other treatment may include obtaining vital signs, warm packs, application of antibiotic ointment and coverage of any draining area.
3) The nursing department will observe for worsening symptoms and call the physician’s office as necessary. If the culture report is positive for MRSA, physician should be notified. Antibiotic treatment may be instituted.
4) The student should come to the nursing department for dressing changes at least 2-3 times per day or as instructed. Any contaminated dressings should be disposed of properly and the area of examination cleaned with antibacterial wipes.
5) All staff should use universal precautions and barriers when exposed to any drainage. Towels, sheets and clothing coming in contact with the drainage should be washed and dried in the dryer. Students may need assistance with this task.
6) No sharing of personal items
7) Student should be reminded to leave the dressing intact and wash their hands frequently.

Actions when a staff is infected with MRSA:
1) If staff have any type of skin infection which is warm, red, swollen, painful or draining they should seek medical attention from their primary care physician.
2) The draining wound should be covered with a clean, dry bandage that contains the drainage.
3) If the drainage cannot be contained or you have fever greater than 101, you should not be at work.
4) The dressing should remain intact; skin to skin contact should be avoided.
5) Staff should engage in frequent hand washing or sanitizing
6) Report any infection and treatment to HR representative.

Precautions:
• Frequent hand washing is the single most important preventive measure to avoid infection with MRSA. Keep your hands clean by washing thoroughly with soap and water or using an alcohol-based hand sanitizer.
• Keep cuts and scrapes clean and covered with a bandage until healed.
• Avoid contact with other people’s wounds or bandages.
• Avoid sharing personal items such as towels or razors.
• Avoid unnecessary use of antibiotics.
• Additional material on MRSA can be found at the CDC web site: http://www.cdc.gov/Features/MRSAinSchools/