Policy 1330: Medical Student Exposure to Bloodborne Pathogens

Policy Number: 1330

Date Approved: 06/03/2025

Executive Responsibility: Executive Committee

Applies To: Medical Students

  • Residents: see needle stick procedure in the policy section of New Innovations

References: Wright State University Policy 13350; BSOM Formaldehyde Exposure Policy; LCME Element 12.8

1330.1 Purpose

In accordance with LCME element 12.8:

"A medical school has policies in place that effectively address medical student exposure to infectious and environmental hazards, including the following:

  • The education of medical students about methods of prevention.
  • The procedures for care and treatment after exposure, including a definition of financial responsibility.
  • The effects of infectious and environmental disease or disability on medical student learning activities.

All registered medical students (including visiting students) are informed of these policies before undertaking any educational activities that would place them at risk.”

1330.2 Policy

The Boonshoft School of Medicine (BSOM) follows the Wright State University (WSU) Policy 13350 on non-occupational exposure to bloodborne pathogens. This includes assuming expenses for immediate health care services provided to an exposed individual that are over and above their insurance coverage.

1330.3 Care and Treatment After Exposure

BSOM students should follow the WSU Environmental Health and Safety (EHS) procedures upon an exposure to bloodborne pathogens.

Immediate Action Required:

  • Wash needlesticks 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 for 15 minutes.
  • Report the incident to your supervisor.
  • Seek medical treatment as soon as possible.
  • Note the patient’s name, location where exposure occurred, the date and time of exposure, rotation you were on, names of witnesses, and type of needle.
  • If the patient’s blood can be tested, it should be tested for HIV, HCV, HBV. If the patient’s blood cannot be tested, the student should be tested.
  • Seek immediate medical attention in either an ED, urgent care, PCP, or student health clinic. Do not go to employee health.
  • Utilize your student insurance for all related visits, labs, and interventions.
  • Consider HIV prophylaxis, if indicated or in doubt (after discussion of the risks and benefits, student will be given a 96-hour supply and counseled on the non-negotiable follow-up within those 96 hours).
  • Tell the Associate Dean of Student Affairs (ADSA) as soon as possible.
  • Send the ADSA copies of whatever records you have (via secure file sharing) as soon as possible but not later than 96 hours.
  • Financial charges not covered by the student’s insurance will be covered by OSAA. Send the ADSA the receipt after it gets run through insurance and you pay the bill.

The EHS Incident Report Form must be completed.

If a needlestick or sharps injury has taken place, additionally complete the Needlesticks or Sharps Injuries Form and email to EHS (ehs@wright.edu).

1330.4 Methods of Prevention and Risk Minimization

All students must follow policies and procedures according to the most current published CDC guidelines regarding use of precautionary measures to minimize the risk of HBV, HCV, and HIV transmission as well as any and all communicable diseases. Students must practice these precautions:

  • Complete appropriate CITI training in bloodborne pathogen and protective equipment, as assigned annually.
  • Routinely use appropriate barrier precautions to prevent skin and mucous membrane exposure when contact with blood or other body fluids of any patient is anticipated. Examples of protective barriers include gloves, gowns, masks, and protective eyewear.
  • Wear gloves when touching blood and body fluids, mucous membranes or non-intact skin of all patients; when handling items or surfaces soiled with blood or body fluids; and when performing venipuncture and other vascular access procedures. Gloves should be changed after contact with each patient.
  • Wear masks and protective eyewear or face shields during procedures that are likely to generate droplets or splashes of blood or other body fluids to prevent exposure of mucous membranes of the mouth, nose, and eyes. Fluid-resistant gowns or aprons should be worn during procedures that are likely to generate splashes of blood or other body fluids.
  • Wash hands before and after contact with patients and immediately after protective gloves are removed. Hands and other skin surfaces should be washed immediately and thoroughly if contaminated with blood or other body fluids.
  • Take precautions to prevent injuries caused by needles, scalpels, and other sharp instruments or devices during procedures.
  • Take precautions when cleaning used instruments, when disposing used needles, and when handling sharp instruments after procedures.
    • To prevent needlestick injuries, needles should NEVER be recapped, purposely bent or broken by hand, removed from disposable syringes or otherwise manipulated by hand.
    • Used, disposable syringes and needles, scalpel blades and other sharp items should be placed in puncture resistant containers for disposal.
    • Large-bore, reusable needles should be placed in puncture-resistant containers for transport to the reprocessing area.
  • Use mouthpieces, resuscitation bags, or other ventilation devices whenever possible for emergency mouth-to-mouth resuscitation.
  • Refrain from all direct patient care and from handling patient-care equipment if you have exudative lesions or weeping dermatitis until the condition resolves or the areas are adequately protected.

1330.4.1 Pregnant and/or Immunocompromised Students

Students who are pregnant or immunocompromised for any reason should be especially familiar with and strictly adhere to precautions to minimize the risk of bloodborne pathogen exposure. Students do not need to disclose their medical status in order to obtain appropriate protective equipment, but they may need to request it. If you are not provided with appropriate preventative equipment by your clinical site, please contact the Office of Student Affairs and Admissions (OSAA) as soon as possible.

Students who are pregnant, breastfeeding, or have other health conditions that may affect their experience within the anatomy lab must comply with the BSOM Formaldehyde Exposure Policy.

1330.5 Effects of Infectious and Environmental Disease or Disability on Medical Student Learning Activities

Students who know, believe, or have reason to believe that they are infected with HIV, HCV or HBV must report that fact to the Associate Dean for Student Affairs and Admissions (ADSA) prior to engagement in any activity where there is a risk of contact between the blood or body fluids of the student and the blood or body fluids of others. The ADSA will require confirmation from a qualified physician as to the student's diagnosis, state of health, and symptoms.

Having identified a student with HBV, HCV and/or HIV, the ADSA will coordinate an ad hoc committee including, if possible, the student's physician, an infectious disease specialist or credentialed HIV specialist, and the Associate Dean for Medical Education or appointee who is familiar with the clinical curriculum. The ad hoc committee will evaluate the student's course work and patient contact to determine appropriate clinical curricular changes based on guidelines from the Ohio Department of Health and the Center for Disease Control. The committee shall report any recommendations to the ADSA who in turn will notify the student and clerkship directors, as needed, of any requirements and/or limitations placed on the student's clinical activity. A student who fails to comply with the requirements and/or limitations will be subject to discipline up to or including a recommendation for dismissal.

All information regarding the HBV, HCV, and/or HIV status of a student shall be held in strict confidence.