Following the recommendation of the American Association of Colleges of Nursing and Robert Morris University, this policy has been developed regarding responsibilities for adherence to the Centers for Disease Control (CDC) and Occupational Safety and Health Administration (OSHA) guidelines for prevention of transmission, as well as recognition of individual rights, voluntary testing, and confidentiality of test results and health records for both faculty and students and for those for whom they provide care.
Faculty need to be educated according to current Occupational Safety and Health Administration (OSHA) guidelines. The Administration/Faculty in the Department of Nursing are responsible for disseminating information about human immune deficiency virus/hepatitis B virus (HIV/HBV) infection and its transmission and educating students about the hazards involved in contact with a diverse population in which HIV/HBV may be present. The curriculum must reflect content related to HIV/HBV and the practice of "universal precautions".
The Nursing Lab Coordinator will have responsibility for educating and updating School of Nursing and Health Sciences faculty and staff regarding changes in either OSHA or CDC guidelines. This lab coordinator will report annually to the total faculty regarding adherence to these guidelines.
Prevention of Transmission
Students will receive printed and verbal information and instructions on universal precautions for body fluids and bloodborne infections in accordance with applicable CDC guidelines prior to any exposure to clients, or to laboratory infectious materials, as well as appropriate information regarding personal health habits, HIV/HBV prevention, and risk behaviors as a part of prerequisite clinical preparation.
Laboratory safety guidelines must be employed for the handling of blood and body fluids of all persons in teaching laboratories. Laboratory courses where exposure to blood is possible must use disposable equipment; this equipment must not be re-used or shared. Disposal of used equipment shall be in accord with both CDC and OSHA Guidelines.
Strict Adherence to Universal Precautions
The Guidelines (universal precautions) established by the CDC , OSHA, and the United States Public Health Services, must be strictly adhered to for the protection of students, faculty, and patients.
All degree seeking undergraduate and graduate students and post master's students must present evidence of a completed series of HBV immunization prior to the start of clinical unless they have documented evidence of immunity to the disease or have signed an informed consent waiver. If students do not have evidence of vaccination, placement for clinical practice could be denied.
Students who refuse to obtain immunization must sign the appropriate waiver stating that they have received information regarding the seriousness of hepatitis B but have decided not to obtain the hepatitis B vaccine.
The Department of Nursing is not responsible for student costs of the HBV vaccine.
Nursing students and faculty who are at risk for HIV and who have a desire to be tested can avail themselves of testing and pre and post testing counseling through the Allegheny County Health Department or Student Health Services.
HIV testing requires written informed consent which must be preceded by an explanation of the test, its purposes, potential uses, limitations and the meaning of results. It is the responsibility of the physician or designee to provide for the informed consent discussion. Pretest counseling must also be provided. Pretest counseling involves making information available to the individual about measures for prevention of exposure to transmission.
Such counseling may be provided either by clinical institutions in the case of an exposure during clinical experiences, by the Allegheny County Health Department. Follow-up testing and counseling will be provided by the testing agency in accordance with their policies and procedures. Without the express written authorization of the individual, results of testing may not be disclosed except as provided for in Pennsylvania's Confidentiality of HIV Related Information Act (the Act) effective February 27, 1991. Subsequent disclosure of HIV related information by such persons is prohibited unless authorized by the individual or permitted by the Act.
Participation in Care of Infected Patients
Since nurses provide "services with respect for human dignity and the uniqueness of the client, unrestricted by considerations of social and economic status, personal attributes, or the nature of health problems" (ANA Code of Ethics for Nurses with Interpretive Statements, 2001), faculty or students may not refuse to participate in the care of infected patients or any other type of patient. Under unusual circumstances (such as open lesions or weeping dermatitis) this ethical mandate may be reconsidered; health care workers with open lesions or weeping dermatitis should refrain from all direct patient care and from handling equipment until the condition resolves.
Management of HIV Infected Faculty or Students
Decisions regarding faculty or students who are infectious with HIV/HBV will be made on a case by case basis considering compliance with universal precautions, health status, and CDC recommendations for preventing transmission of HIV/HBV.
Exposure to HIV/HBV
Students and faculty members have a responsibility to report to faculty members in charge or designated administrators any incident which exposed them or a patient to risk of transmission of blood borne disease. Faculty or students who are exposed to HIV/HBV by needle puncture or contact with secretions/body fluids while in the clinical setting should conform to specific agency procedures for such contact. Faculty/students must request an evaluation of the significance of the exposure as soon as possible or within 24 hours after the exposure.
Guidelines for follow-up evaluation and documentation of the exposure should be in accordance with the Health Incidents policy.
Faculty Approval: 2004
Faculty Review: 9/2007
Faculty revised: 12/2009