Needlestick Protocol and Procedure

needlestick protocol and procedure

Exposure to Blood and Body Fluids

You have already performed physical exams on patients in the hospital and are probably aware of the proper procedures for Universal Precautions. Nonetheless, a few extra words of caution are warranted. It cannot be stated too strongly that you are in the clinics to learn! This means that you will be performing procedures for the first time. You may be nervous and feel inexperienced. YOU ARE NOT REQUIRED TO PUT YOURSELF AT RISK. If you feel uncomfortable about the circumstances surrounding a procedure (i.e. the patient is thrashing around on the bed as you try to draw blood), DO NOT DO IT! Additionally, you will sometimes encounter situations where residents or attendings are not following universal precautions (e.g. wearing one pair of gloves in the OR) and you will be tempted to follow their example so as not to draw attention to yourself. THINK ABOUT IT: THIS MAKES NO SENSE. You have an entire career ahead of you. This is no time to be taking undue risks.

Penn Med policy regarding potential exposures is as follows:

Any medical student who sustains a needlestick or other wound resulting in exposure to blood or body fluids should follow the following protocol. Please keep in mind, that drug prophylaxis following a high-risk exposure is time sensitive, therefore you must immediately seek help from the appropriate hospital department.

Immediately wash the affected area with soap and water and cover the area with a dressing if possible. For an ocular exposure, flush thoroughly with water. Inform the supervising resident and immediately report to the areas listed below. Please bring the source patient information with you.

At HUP, the VA or CHOP

Go directly to HUP’s Occupational Medicine Division.

If they are closed, report to the HUP Emergency Department.

Identify yourself as a medical student who has just sustained an exposure.

You will see health care provider who is trained in assessing the risk of the exposure. If you are seen in the Emergency Room, an occupational medicine doctor is on-call 24 hours a day to provide immediate consultation on post-exposure drug treatment and counseling. Do not hesitate to ask the physician treating you to page the Occupational Medicine doctor carrying the needlestick pager.

You will be counseled and advised about post-exposure prophylaxis, if necessary.

If indicated, you will be given a starter pack of the prophylactic drugs

which are recommended in accordance with the current guidelines of the

Center for Disease Control.

Base-line blood tests will be done on you.

The physician at Occupational Health will contact the attending physician of the source patient to expedite the process of getting consent to test the source patient.

You will be given a schedule as to when to return to Occupational Medicine for follow-up testing.

If you are at the following hospitals, please go to the place listed. You will be treated in accordance with the hospital’s needlestick policy for healthcare workers. All affiliated hospitals’ needlestick policies have been reviewed by the Director of Infection Control for HUP and meet established standards. All follow-up testing for the students is done at HUP Occupational Health. Students should bring their records to HUP Occupational Health so that appropriate follow-up testing can be scheduled.

Chester County Hospital – Report to the Emergency Department.

Chestnut Hill Hospital – Report to the Emergency Department.

Englewood Hospital – Report to the Employee Health service between the hours of

8:00 am – 4:00 pm or to the Emergency Room after those hours.

Pennsylvania Hospital - Report to Employee Health or to the Emergency Room if they are closed.

Presbyterian Hospital – Report to Occupational Medicine or to the Emergency Room if they are closed.

St. Luke’s Hospital – Report to the Emergency Department.

Underwood Memorial Hospital – Report to Employee Health or to the Emergency Room if they are closed.

Virtua Health - Report to Occupational Health or to the Emergency Room if they are closed.

York Hospital - Report to the Employee Health Service or call the Safety Hotline at extension 4444 if they are closed.

Outpatient Ambulatory Sites - Report to HUP Occupational Medicine or to its satellite at Radnor, whichever is a closer distance to your site.

Billing Procedures

All expenses that a student incurs, associated with needlesticks, will be paid for by the School of Medicine. At HUP or Presbyterian, these charges should automatically be billed to the School. However, if you do receive a bill for any of these services, please bring it to Nancy Murphy in the Office of Student Affairs immediately, so that the charges can be transferred to the school account. At affiliated hospitals, typically the bill will be sent to your home address. Please bring it to Nancy Murphy immediately so that the School of Medicine can pay the bill.

Additional Assistance

If you have difficulty getting the consent of the source patient, or any other problems associated with your needlestick, please contact Dr. Jon Morris, Associate Dean for Student Affairs, at 215-898-7190, 215-662-2131 or cell 215-313-6990.