27 Occupational Health Risks

a. Understanding the risk

b. Proper work practices

c. Engineering controls

d. Disposal of regulated waste

1. 4. Post exposure procedure, evaluation and treatment.

Exposure Determination and Protection:

A. Persons at risk of exposure

1. 1. Faculty working in the Health Programs at North Idaho College.
   2. Students attending the Health Programs at North Idaho College.

B. Task and procedures involved in occupational risks

1. Specific tasks and procedures included, but not limited to:

• • Oral care
  • Emptying bedpans and urinals
  • Collection of specimens such as sputum, blood, fecal, wound drainage.
  • Cleaning and dressing open wounds
  • Parenteral injections
  • Starting, discontinuing and managing intravenous lines and catheters
  • Oral and tracheal suctioning

2. Specific jobs:

• • Student: Meeting the needs of patients in a progressive manner as determined by the job description utilized in an acute care, extended care, emergent care, clinic, psychiatric, and cancer center facilities. The student will carry out only those tasks and procedures in a clinical setting after being taught and practiced in pre-clinic or a learning laboratory on campus.
  • Faculty: Supervision, assistance and/or oversight of students in meeting the needs of patients.

3. Method of compliance:

1. 1. All Health students and faculty will have the series of HBV vaccines prior to beginning the first clinical experience and a follow-up titer six (6) months after the completion of the series.
   2. Should the titer be negative, a booster HBV vaccine will be given.
   3. All Health students and faculty will maintain current on immunizations and health requirements as outlines in the Clinical Passport Requirements.
   4. Students in the Health Programs are taught and practice prior to clinical experience working with patients:
      • Universal precautions, which includes wearing the appropriate protective clothing and equipment.
      • Aseptic hand washing techniques.
      • Prior to starting clinical or treating patients, students are taught the correct procedure for safe disposal of sharps.
      • Prior to starting clinical or treating patients, students are instructed on the correct procedure for specific tasks and procedures that involve potential contact with blood and body fluids, especially, but not limited to:

• • • • Collection of specimens
      • Cleaning and dressing open wounds
      • Parenteral injections
      • Starting, discontinuing and managing intravenous lines and catheters
      • Oral and tracheal suctioning
      • Oral health procedures

4. Implementation of plan:

• • Health students and faculty follow procedures that have been implemented in each facility.
  • Students and faculty maintain current immunizations as identified on the Clinical Passport Requirements.
  • The learning lab, simulation lab and pre-clinic are set up to ensure practice of universal precautions, using preventative clothing and equipment. Students are trained on use of universal precautions and protective equipment.

Procedure for needle stick/body fluid splash:

All contaminated needle sticks or bloody body fluid splash to mucus membrane or open skin should be treated as if there is a potential risk of pathogen exposure.  If an exposure takes place in an experiential education facility the student will be required to follow the procedure(s) outlined below, as well as, complete any appropriate facility requirements and forms.  If the student receives an exposure to blood or body fluid:

A. Provide immediate care to the exposed site:

• • Wash needle sticks and cuts with soap and water
  • Flush splashes to the nose, mouth, or skin with water
  • Irrigate eyes with clean water, saline, or sterile irrigants

No scientific evidence shows that using antiseptics or squeezing the wound will reduce the risk of transmission of a blood borne pathogen. Using a caustic agent such as bleach is not recommended.

B. Notify Clinical Instructor, Team Lead Instructor, Director of the Program or the Dean of Health Professions and Nursing immediately.

C. Fill out a college incident report (see Incident/Injury Report) and return to the Director of the Program within 24 hours to be kept in the student file.

D. A copy of the incident report is to be taken to NIC Student Health, to be placed in the student/faculty health file.

E. The Infection Control or Occupational Health Department from the facility involved need to be contacted with follow-up instructions. A copy of the follow-up instructions should be provided to the Director of Nursing to be kept in the student file.

F. Complete all appropriate facility requirements and forms for the facility where the exposure occurred.

Procedure for an accident or injury in clinical setting: 

If an accident or injury occurs involving the student or a patient(s) they are caring for in the clinical setting, the student should do the following:

1. In the event that a patient is injured in the student’s presence, insure the safety of the patient from further injury and report the incident to the supervisor immediately. All incidents involving patients, visitors or students, no matter how minor, must be reported.  The facility supervisor, site or lead instructor will assist with completing appropriate forms.
2. Notify Clinical Instructor, Team Lead Instructor, Director of the Program/Dean of Health Professions and Nursing immediately.
3. If the student is injured, seek immediate treatment as needed.
4. Notify Employee Health of the facility for the facility.
5. Complete all appropriate facility requirements and forms for the facility where the incident occurred.
6. Complete an NIC incident report and file with the Director of the Program within 24 hours to be kept in the student file.
7. A copy of the incident report is to be taken to NIC Student Health, to be placed in the student/faculty health file.
8. Student should follow-up with care provider.
9. If a student has a prescribed restriction on physical activity, a physician’s written directive must be provided to the Program Director. The student will also need to provide the Director of the Program with a written release from any physical restrictions once they have been granted by the healthcare provider.

References:

Center for Disease Control (July 2003). Exposure to Blood:  What Healthcare Personnel Need to Know.  Retrieved from https://www.cdc.gov/HAI/pdfs/bbp/Exp_to_Blood.pdf

United State Department of Labor.  Occupational Safety and Health Administration.  Retrieved from:  https://www.osha.gov/