Exposure to Infectious Diseases in Clinical Settings

This information is to advise Creighton University's students, faculty and staff of the steps that should be taken when exposed to potentially infectious blood or body fluid while in a clinical setting.

*NOTE:  If you receive an injury from a sterile instrument or needle this protocol does not apply. 

Immediate Response to Exposure and Initiation of Evaluation and Treatment

In case of suspected exposure to blood or body fluids in the academic or clinical setting, the exposed individual should:

STOP current activity.
CLEANSE any wound with soap and water.  Flush eyes with water after any splash exposure.
SEEK evaluation and treatment, ideally within one hour of exposure
REPORT to your supervisor/faculty and the appropriate facility/institutional supervisor.

Secondary Response

After the immediate response, the individual should follow the process defined below based on the facility in which the possible exposure incident occurred.

A.    Exposures at CHI facilities
    
    a.    Locate the “Red Folder,” which is available in all clinical settings, and follow all directions
    b.    Submit CHI Incident Report form or Creighton HR 24 Incident Report Form  to Creighton Risk Management (either via fax to 402-280-5780 or via encrypted e mail to risk@creighton.edu).

B.    Exposures at Dignity
    a.    Notify the Supervisor
    b.    Notify Dignity Employee Health and follow all procedures
    c.    Submit Creighton HR 24 Incident Report Form  to Creighton Risk Management (either via fax to 402-280-5780 or via encrypted e mail to risk@creighton.edu).

C.    Exposures at MIHS
    a.    Notify the Supervisor
    b.    Notify MIHS Environmental Health and Safety office and follow all procedures
    c.    Submit Creighton HR 24 Incident Report Form  to Creighton Risk Management (either via fax to 402-280-5780 or via encrypted e mail to risk@creighton.edu).

D.  Exposures at Creighton School of Dentistry

    a.    Student goes to the Clinical Administrative Coordinator’s office to pick up an HR-24 Incident Report for completion (submit form to Creighton Risk Management (either via fax to 402-280-5780 or via encrypted e mail to risk@creighton.edu) and an information sheet outlining instructions; one for themselves and the other for the patient.
    b.  Student and patient will go to the CHI University campus facility at 2412 Cuming St. Proceed to the CHI University Family Practice Clinic located on the 2nd floor, Suite 200.

Hours of operation:
Monday – Thursday 8:00 am -7:30 pm
Friday – 8:00 am – 4:30 pm
(NOTE: If an incident occurs later than 4:30 pm on a Friday, the student and patient will proceed to the CHI University campus EMERGENCY ROOM located at 2412 Cuming St.)

-    The student and patient will be seen by one of the Family Practice providers
-    Labs will be ordered and drawn
-    Once results come back the provider will notify patients
-    The results will be sent to Risk Management at Creighton University and the School of Dentistry
-    The billing process will work as follows:
     Student – Insurance will be billed; for any charges out of pocket, students will submit the bills to Winston Yapp, Creighton University School of Dentistry for payment
     Patient – The clinic will direct bill the School of Dentistry to the following:

Creighton University School of Dentistry
Attn: Winston Yapp
2109 Cuming Street
Omaha, NE 68102

E.    Exposures at  Creighton Therapy and Wellness, Creighton Outpatient Pharmacy, the Student Health Education and Compliance Office or Health Events on Campus (Creighton or Phoenix)
    a.    Locate the “Red Folder” and follow all procedures
    b.    Submit Creighton HR 24 Incident Report Form  to Creighton Risk Management (either via fax to 402-280-5780 or via encrypted e mail to risk@creighton.edu).

F.    Exposures at all other facilities and health events
    a.    Follow facility’s protocol.  Where there is no facility specific protocol, request procedure for source patient testing. Person exposed should receive baseline testing at local Emergency Department.
        i.    Laboratory testing recommended:
            1.    Source patient- Rapid HIV, Hepatitis B Surface Antigen, Hepatitis C Antibody
            2.    Person exposed (baseline testing) - HIV 1 and 2 Ag/Ab, Hepatitis B (if antibody status unknown), and C Surface Antibody.
    b.    Send a copy of the facility’s incident report form or Creighton HR 24 Incident Report Form  to Creighton Risk Management (either via fax to 402-280-5780 or via encrypted e mail to risk@creighton.edu).

G.    Exposures Out of USA
    a.    The sponsoring School at the University shall be responsible for identifying a program contact person to arrange for appropriate medical care and intervention for all Creighton sponsored experiences outside the USA, including ILAC.

Refusal of Evaluation and Treatment

The supervisor shall advise the individual of the risks/benefits of evaluation and diagnostic testing.  If the exposed individual refuses to seek evaluation and diagnostic testing, the refusal of evaluation and diagnostic testing shall be noted on the incident report form and signed by the individual. A copy of the facility’s incident report form or Creighton’s HR 24 Incident Report Form shall be sent to Risk Management (either via fax to 402-280-5780 or via encrypted email to risk@creighton.edu).

Request for Source Testing

Any requests to test the source patient must be made to the clinical facility where the incident occurred. Normally, the person who was exposed will not be the person requesting test permission from the source patient.  The on-site supervisor is the preferred person to request consent from the source patient.   Source patients have the right to refuse testing or sharing test results with persons exposed. Any such refusal shall be documented in the Incident Report