Wright State University School of Medicine
Sponsored Graduate Medical Education Programs
Resident Manual

Item 402
Infection Control

Revised June 2006; Employee Health Contact List Updated February 19, 2008

1. Physicians in the State of Ohio who are infected with HIV or HBV and who perform invasive procedures must follow rules set out by the Ohio State Medical Board (Administrative Rules Chapter 4731-19, Licensees Infected with HIV or HVB: Reporting Requirements and Duty of Care Requirements, http://www.state.oh.us/med/rules/4731-19.htm).

2. Wright State University School of Medicine and Dayton Area Graduate Medical Education Consortium Policy: Management of Residents Having an Occupational Exposure to Bloodborne Pathogens

Since a bloodborne pathogen exposure places an individual at risk for hepatitis B virus (HBV), hepatitis C virus (HCV), and human immunodeficiency virus (HIV) infection, it is important that one seeks medical attention as soon as possible after an exposure occurs. Any resident who sustains an exposure to blood or body fluids should be managed according to currently recommended guidelines from the Centers for Disease Control and Prevention (CDC) and according to the policies and procedures of the institution. Proper steps must be taken to ensure that both evaluations and preventive measures are instituted in a timely manner. The steps noted below should be followed when an exposure occurs in a resident participating in a Wright State University Boonshoft School of Medicine (WSU BSOM)-affiliated or -sponsored residency program.

a. The exposure site should be cleansed thoroughly immediately following the exposure. Irrigate eye with water keeping the affected eye lower than the unaffected eye during irrigation.

b. Note the patient's name, the location where the exposure occurred, the date and time of the exposure, the rotation, the names of witnesses, and, in the case of a needlestick, the type (hollow bore or solid).

c. Notify the employee health office in the hospital or the safety officer in a private setting during regular working hours. Report to the emergency department during evenings, nights and on weekends. A list of employee health office contacts is at the end of this policy.

d. The exposed resident should be managed according to the institution's policy on management of an employee following a percutaneous or permucosal occupational bloodborne exposure.

e. All laboratory evaluations should follow the recommended institutional policies.

f. If appropriate, after assessments are performed and based on current guidelines, the resident may be offered antiviral prophylaxis against HIV. After discussion of the risks and benefits of antiviral prophylaxis, any resident not employed by the institution where the exposure occurred should be dispensed a 96-hour supply of the antiviral medications. A resident employed by the institution should be managed according to policy. All exposed individuals must be counseled on the importance of follow-up evaluations. Each must have a follow-up evaluation at the base institution within 96 hours of the exposure. Follow-up of the resident must be ensured. The following should be done.

(1) Notification must be given to the employee health service of the resident's base institution, as soon as possible but not later than 96 hours following the initial evaluation. (Please see list of contact addresses and telephone/FAX numbers at the end of this policy.)

(2) Ensure that copies of all records are confidentially forwarded as soon as possible but not later than 96 hours following the initial evaluation to the employee health service of the institution that serves as the fiscal agent for the resident.

(3) The resident must be instructed on the requirement for follow-up evaluations within the 96-hour period. Appropriate educational and medical support must be provided. This should be coordinated at the base institution of the resident.

g. Financial charges incurred during the evaluation should be forwarded to the employee health service of the exposed resident's base institution.

Resident Post-Exposure Policy
Employee Health Contacts per Hospital
List Updated February 19, 2008

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