Purpose: It is the policy of Hillcrest Educational Centers (HEC) to provide a safe and healthy work environment which includes proper management of exposure to potentially contaminated blood and/or body fluids. These procedures are meant to ensure that appropriate measures are taken to protect those at risk of exposure.
Background: OSHA estimates approximately 5.6 million workers in health care and other facilities are at risk of exposure to bloodborne pathogens such as the human immunodeficiency (HIV), hepatitis B (HBV) virus, hepatitis C (HCV) and other potentially infectious diseases. Those at risk include anyone whose job may require providing first-response medical care in which there is a reasonable expectation of contact with blood or other potentially infectious materials. Common exposure in settings like HEC may occur from human bites. Although they are rarely associated with the transmission of HIV or HBV infection they are associated with a significant risk for serious bacterial infection and require proper medical treatment. Prevention of exposures is critically important. Regular hand washing, appropriate use of gloves and training are steps that contribute to the prevention of complications from these exposures.
Vaccinations and Incident Reporting
HEC has a vaccination program through Occupational Health Services. This program is offered at no cost to all employees upon being hired and again to those who have an occupational exposure to bloodborne pathogens. In the event of employee exposure to bloodborne pathogens, post-exposure evaluation and follow-up will be provided at Occupational Health Services. Following any exposure incident, the affected employee should immediately report to the campus nurse on duty during normal business hours. After hours, employees are instructed to report to the Berkshire Medical Center Emergency Room. An ART form AND Post Exposure Work Sheet should be completed by the nurse, faxed to Employee Health Representative at HR, a copy should be given to the Program Manager and the original sent with the employee for further documentation by the treating physician.
Procedures after bite exposure (Student to Student or Student to Staff)
• Immediately wash the site for 5 minutes with soap and water or flush eyes with normal
saline or tap water for 15 minutes (remove and discard contact lenses) Mild bleeding should be allowed to continue
• If there is blood in the biter’s mouth it should be rinsed and spit with tap water several times
• Report the injury to a supervisor
• Contact or go to campus Nursing Department who will make an assessment and refer to pediatrician, Occupational Health Services or Emergency Department as necessary
• Initial assessment includes skin integrity (is the skin broken), documentation of the incident and those involved, and initial wound care
• If after hours, go to the Emergency Room for evaluation of a bite that has broken the skin
• Complete incident report form, ART Form and Post Exposure Worksheet. Enter a progress note in the appropriate system.
• Obtain a medical history on the source patient (biter) and have blood specimens drawn within the first 8-10 hours after exposure (consent must be obtained): Rapid HIV and Hepatitis panel. Bites occurring after Nursing hours will have arrangements made to be drawn the next morning. (Previously drawn labs are acceptable if dated in the past 60 days)
• Employees referred to Occupational Health or ER will receive an assessment and treatment which may include but is not limited to tetanus update, antibiotics, and several blood tests as recommended by treating Physician. Treatment options will be discussed on an individual basis.
• Report the results of blood testing of the source (biter) to Occupational Health as soon as available (within 24 hours if rapid HIV done). The status of the Employee should be reported to the campus at this time. If there are positive reports at any time, The Medical Directors of both HEC and Occupational Health will be notified immediately. Referral for appropriate counseling and treatment will be made.
• If exposure occurs when there is no nurse available, a call should be placed to the campus on call Nurse to decide the course of action.
Procedures after body fluid exposure (Student to Student or Student to Staff)
In the event of an accidental exposure to blood or body fluids (e.g., needlestick, blood or body fluid contamination to a cut or scrape, mucous membrane exposure)
• Immediately wash the area for 10 minutes with soap and water or flush eyes with normal
saline or tap water for 15 minutes (remove and discard contact lenses)or rinse mouth for several minutes
• Report the injury to a supervisor
• Contact or go to campus Nursing Department who will make an assessment and refer to pediatrician or Occupational Health Services as necessary
• Initial assessment includes skin integrity (is the skin broken), documentation of those involved, and initial wound care
• If after hours, go to the Emergency Room for evaluation
• Complete incident report form, ART Form and Post Exposure Worksheet. Enter nursing note in appropriate system.
• Obtain a medical history on the source patient and have blood specimens drawn within the first 8-10 hours after exposure (consent must be obtained): Rapid HIV and Hepatitis panel. Bites occurring after Nursing hours will have arrangements made to be
drawn the next morning.(Previously drawn labs are acceptable if dated in the past 60 days)
• Employees referred to Occupational Health or ER will receive an assessment and treatment which may include but is not limited to tetanus update, antibiotics, and several blood tests as recommended by treating Physician. Treatment options will be discussed on an individual basis.
• Report the results of blood testing of the source (biter) to Occupational Health as soon as available (within 24 hours if rapid HIV done). The status of the Employee should be reported to the campus at this time. If there are positive reports at any time, The Medical Directors of both HEC and Occupational Health will be notified immediately. Referral for appropriate counseling and treatment will be made.
• If exposure occurs when there is no nurse available, a call should be placed to the campus on call Nurse to decide the course of action.