Download Section 14 Management of Exposure to Blood

Section 14 Management of Exposure
to Blood-borne Infection
TABLE OF CONTENTS
Definitions
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Exposure
1
Sharps Safety Devices
1
General Policy
2
Procedure for Exposures within the College of Dentistry
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Procedure for Exposures that Occur at the Community Partner Sites
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Management of Splashes into the Eye
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UIC COLLEGE OF DENTISTRY
INFECTION CONTROL MANUAL
MANAGEMENT OF EXPOSURES TO BLOOD-BORNE INFECTION
SECTION 14
Management of Exposures to Blood-borne
Infection
Definitions
Exposure
A person is considered exposed to a blood and body fluids if he/she receives a parenteral
(e.g., needlestick or cut) or mucous-membrane (e.g., splash to the eye, nasal mucosa, or
mouth) exposure to blood or other body fluids or has a cutaneous (skin) exposure involving
large amounts of blood or prolonged contact with blood - especially when the exposed skin
is chapped, abraded, or afflicted with dermatitis.
Note: This policy is to be followed for all staff and students who have an exposure to blood
or bodily fluid.
Sharps Safety Devices
Engineering Controls now includes safer medical devices, such as sharps with engineered sharps injury
protections and needleless systems. Engineering Controls still include all control measures that isolate or
remove a hazard from the workplace including medical devices designed to reduce the risk of percutaneous
injuries.
•
Sharps with engineered sharps injury protection, which OSHA defines as "a nonneedle sharp or a needle device used for withdrawing body fluids, accessing a
vein or artery, or administering medications or other fluids, with a built-in safety
feature or mechanism that effectively reduces the risk of an exposure incident";
•
Needleless systems describes devices that do not use needles to collect bodily
fluids or withdraw body fluids (after initial vascular access is established),
administer medication or fluids, or perform any other procedure involving the
potential for occupational exposure to blood borne pathogens due to
percutaneous injuries from contaminated sharps.
All new sharps safety devices are to be evaluated in various areas in the College of Dentistry
such that input is collected from all levels of clinical and administrative personnel. Based on
the feedback from students, staff and faculty a decision will be made by the Infection
Control Committee on whether to recommend the implementation of the new sharps safety
devices.
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UIC COLLEGE OF DENTISTRY
INFECTION CONTROL MANUAL
MANAGEMENT OF EXPOSURES TO BLOOD-BORNE INFECTION
SECTION 14
General Policy
Management of faculty, staff or students experiencing needlesticks, sharps injuries, or other
exposure to blood/body fluids includes providing for appropriate medical care and
obtaining blood samples from both the exposed person and the source case, if possible.
Serologic testing for HBV, HCV, and HIV will be provided to all DHCWs who are
concerned that they may have become infected.
The College of Dentistry will not assume responsibility for medical expenses incurred by
individuals who do not follow established procedures.
Questions involving infection control policy and procedures should be addressed to the
Office for Clinical Affairs, room 301 (ext. 6-3544).
Procedure for Exposures within the College of Dentistry
1.
Provide self with immediate wound care, which includes washing site with soap and
running water. If exposure is to the eye or mucus membranes flush with running
water only. Inform your supervisor or the Office for Clinical Affairs (room 301) of
the incident. (During boards inform the Chief Examiner)
2. Conclude the procedure in progress as soon as it is reasonable without
compromising patient care, or arrange to have it completed.
3. Obtain verbal consent from the patient for testing for serologic evidence of HBV,
HCV and HIV infection. (Written consent is not required). Patients are taken to
Oral Surgery where blood is drawn by the resident, nurse or faculty member on duty.
(On weekends the patient will be taken with the provider to the Emergency Room)
•
For adults, obtain two 10ml red topped tubes of blood.
•
For pediatric patients, consult the pediatrician and laboratory staff as needed
to determine whether to test and, if so, the amount of blood to draw.
4. Take the blood specimen from the source patient, in a zip-lock bag labeled
“biohazard” to the University Health Services (UHS) or to the Emergency Services
Department (ESD), depending on the time of day or day of the week that treatment
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UIC COLLEGE OF DENTISTRY
INFECTION CONTROL MANUAL
MANAGEMENT OF EXPOSURES TO BLOOD-BORNE INFECTION
SECTION 14
is being sought. (This is the only instance in which students will use the
University Health Service.) The specimens should be labeled with the patient’s
Dental Chart ID Number and Name.
•
Report to University Health Services (UHS):
Medical Science Building
835 S. Wolcott Ave. room E144
7:00 a.m. - 3:00 p.m. Monday through Friday
•
Report to UIC Emergency Service Department (ESD) when UHS is closed.
5. Comply with follow-up procedures .Obtain results and interpretation of source
patient’s test results from UHS.
6. Patient’s test results are confidential.
7. Complete the following reports which are available in your clinic, the “Clinic
Chairside” intranet site, or the Office for Clinical Affairs (room 301) as soon as
possible after the exposure:
• Supervisor’s First Report of Occupational Injury or Illness (employees only)
• Occurrence Report
• Make an entry in the patient’s file in Axium.
8. Fees:
•
•
•
UIC employees are covered by Workers’ Compensation
Students must first submit bills to their health insurance. Any non-covered
portion will be covered by the College of Dentistry. Bring both bills
(Doctor’s Services and Emergency Room) to room 301.
Exposures during boards are not covered by the College.
During Boards anyone hired by a candidate is treated as that
candidate’s employee and the candidate is responsible for their bills.
Procedure for Exposures that Occur at the Community Partner
Sites
1. Provide self with immediate wound care, which includes washing wound site with
soap and running water. If exposure is to the eye or mucus membranes flush with
running water only. Inform the dentist in charge of the incident.
2. Conclude the procedure in progress as soon as it is reasonable without
compromising patient care, or arrange to have it completed.
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UIC COLLEGE OF DENTISTRY
INFECTION CONTROL MANUAL
MANAGEMENT OF EXPOSURES TO BLOOD-BORNE INFECTION
SECTION 14
3. Work with the community partners to follow the appropriate Post-Exposure
Procedures for their site. This should include obtaining the patient’s blood and your
blood and running tests for HBV, HCV and HIV.
•
A list of contacts is available at the end of this section. You should
ultimately speak with the supervising faculty at your community site.
4. Comply with follow-up procedures. Obtain results and interpretation of source
patient’s test results.
5. Patient’s test results are confidential.
6. Complete a the following reports:
•
Any paperwork from the Community Partner’s location
•
A Patient Occurrence Report is to be completed as soon as you return to the
College of Dentistry. This form is found on the intranet site (“Clinic
Chairside”) and should be turned into the Office for Clinical Affairs, room
301.
7. If you receive any bills for the testing or prophylactic medications related to the
exposure incident please:
•
Submit to your health insurance company for initial payment.
•
Submit any unpaid balance to the Office for Clinical Affairs, in room 301
and the University will pay any fees not covered by your health insurance
company.
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UIC COLLEGE OF DENTISTRY
INFECTION CONTROL MANUAL
MANAGEMENT OF EXPOSURES TO BLOOD-BORNE INFECTION
SECTION 14
Where To Go For Blood Test In Case Of Blood-Borne Pathogen Exposure
at Community Partner Sites
Crusader Clinic (Rockford)
Illinois Masonic Medical Center
Infant Welfare Society of Chicago
Lake County Health Dept. Clinic
Lawndale Christian Health Center
Northwest Community Healthcare
Oak Park-River Forest
Infant Welfare Society
Spang Center for Oral Health
Milestone
UFCW Union Medical Center
Erie Family Health Center
Brookside Immediate & Occupational Care
1215 N. Alpine Road Rockford, IL 61107-2299
(815) 391-7800
Illinois Masonic
Occupational Health
811 W. Wellington Chicago, IL 60657
(773)975-1600
Illinois Masonic Medical Center
Occupational Health
811 W. Wellington Chicago, IL 60657
(773)975-1600
Lake Forest Hospital
Occupational Health Services
660 North Westmoreland Road Lake Forest, Illinois
60045-9989
(847) 535-6172
LCHC Ogden site
3851 W. Ogden Ave. Chicago, IL 60623
(773) 521-8243
Northwest Community Hospital
Main location
800 W. Central Road Arlington Heights, IL
(847) 618-1000
West Suburban Hospital
Occupational Health Dept.
3 Erie Court, Oak Park, IL 60302
(708) 453-0744
Heartland Health Outreach
Main clinic
1015 W. Lawrence Avenue, 2nd Fl, Chicago, IL 60640
(773) 751-4107
Brookside Immediate & Occupational Care
1215 N. Alpine Road Rockford, IL 61107-2299
(815) 391-7800
Follow UIC-COD Protocol:
University Health Services
835 S. Wolcott Ave. Room E144
(312) 996-7420
7:30-3:00 Monday through Friday
OR UIC Medical Center Emergency Room
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UIC COLLEGE OF DENTISTRY
INFECTION CONTROL MANUAL
MANAGEMENT OF EXPOSURES TO BLOOD-BORNE INFECTION
SECTION 14
Management of Splashes into the Eye
Either protective eyewear or a chin-length plastic face shield must be worn during dental
procedures in which splattering of blood, or saliva is likely. A face shield does not substitute
for a surgical mask.
Protective eyewear must possess side shields. Protective eyewear consists of goggles or
glasses with solid side shields. Side shields for glasses are available at the dispensing
windows. A full face shield may be worn when using the ultrasonic scaler in addition to a
face mask.
In the event of a splash into the eye, follow this protocol:
 Stop the procedure
 Go to the closest eyewash station
 Turn on eyewash and flush open eye for at least 2 minutes.
 Repeat as necessary
 If possible take someone with you to assist.
 Do NOT rub your eyes!!!
After flushing, report the incident to the Office for Clinical Affairs (room 301) where you
will be directed on how to get medical attention.
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