A "Badge Buddy" is available in the Student Handbook, showing contact information at clerkship hospitals for security concerns, infectious exposure (including needlestick injuries), and environmental exposures. Replacement copies are available through the Office of Student Affairs on the Irvine campus and the Medical Education Office in Orange.

OCCUPATIONAL RISK TRAINING AND PREVENTION

Participation in direct patient care activities can pose risks to health care professionals, particularly in terms of exposure to infectious diseases. The School of Medicine requires that all medical students participate in annual safety training that facilitates students’ anticipation, recognition, and avoidance of potential occupational risks. The School of Medicine also provides practical training in safe practices so that students minimize risk in potentially hazardous situations, such as the Anatomy lab and the operating room. A particular emphasis is placed on strict adherence to universal precautions. Finally, students are required to show proof of immunity to a series of vaccine-preventable diseases as outlined in the AAMC Standardized Immunization Form (see “Health Clearance” page).

UCI SOM POLICY AND PROCEDURES FOLLOWING WORK-RELATED INJURY OR EXPOSURE TO AN ENVIRONMENTAL HAZARD

Students receive training on occupational and environmental hazards as part of their orientation to the school. Students are required to complete an annual online safety training, which reinforces this information.

Students with Graduate Student Health Insurance (GSHIP)

Students who have suffered a work-related injury or are exposed to an environmental hazard at any training site should go directly to Occupational Health or the Emergency Room for immediate evaluation and care.

Students should contact the GSHIP Insurance Coordinator at (949) 824-2388 within 24 hours so that insurance coverage will be authorized and follow-up care can be arranged. Otherwise, the insurance provider is not obligated to cover the cost of the initial care and treatment post-exposure.

For those students who require follow up, students may follow up with the Student Health Center, with consultation available to the provider through Occupational Health.

Students with a private health insurance program

Most insurance plans have provisions, which include the need to report the injury to the insurance company within a brief period after the injury. It is the student’s responsibility to be familiar with the insurance benefits, exclusions and limitations.

For those students who require follow up, students may follow up with their own health care provider, with consultation available to the provider through Occupational Health.

UCI SOM POLICY AND PROCEDURES FOLLOWING OCCUPATIONAL EXPOSURE TO BLOOD/BODY FLUIDS

Students with Graduate Student Health Insurance (GSHIP)

If a student comes in contact with another person’s blood or body fluid (e.g., through a needlestick or sharps injury or contact with skin, eyes, or mucous membranes), they should immediately take the following steps in accordance with CDC guidelines:

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
Report the incident to your supervisor
Immediately seek medical treatment

Go directly to Occupational Health or the Emergency Room immediate evaluation and care post-exposure.
Document the date and time, patient’s name, identification number, and the unit and clinical site in which the exposure occurred. Keep this information in a secure place. In addition, immediately contact the nursing supervisor and provide the supervisor with this information. The nursing supervisor will request and obtain a source patient blood sample for Hepatitis B Surface Antigen, Hepatitis C, and consent for HIV testing, if the patient’s status is not known.
Contact the GSHIP Insurance Coordinator at (949) 824-2388 within 24 hours so that insurance coverage will be authorized and follow-up care can be arranged. Otherwise, the insurance provider is not obligated to cover the cost of the initial urgent or immediate evaluation and care post-exposure.
Follow up care and treatment will be provided by the Student Health Center, with consultation available to the provider through Occupational Health.

Students with a private health insurance program

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
Report the incident to your supervisor
Immediately seek medical treatment

Go directly to Occupational Health or the Emergency Room immediate evaluation and care post-exposure.
Document the date and time, patient’s name, identification number, and the unit and clinical site in which the exposure occurred. Keep this information in a secure place. In addition, immediately contact the nursing supervisor and provide the supervisor with this information. The nursing supervisor will request and obtain a source patient blood sample for Hepatitis B Surface Antigen, Hepatitis C, and consent for HIV testing, if the patient’s status is not known.
Most insurance plans have provisions, which include the need to report the injury to the insurance company within a brief period after the injury. It is the student’s responsibility to be familiar with the insurance benefits, exclusions and limitations.
Follow up care and treatment will be provided by your own health care provider, with consultation available to the provider through Occupational Health.

Resources

Detailed management protocols for exposure to blood-borne infections can be found on the Center for Disease Control and Prevention website at: http://www.cdc.gov/niosh/topics/bbp/emergnedl.html

IMPLICATIONS OF INFECTIOUS AND/OR ENVIRONMENTAL DISEASE OR DISABILITY ON MEDICAL STUDENT EDUCATIONAL ACTIVITIES

Students with infectious and/or environmental disease or disability are encouraged to seek counseling with the Student Health Center or their preferred medical provider. While Calfornia law does not require disclosure of chronic bloodborne viral infections (such as Hepatitis B, Hepatitis C, and HIV), students with these diseases are highly advised to seek educational and career counseling through the Student Health Center. The Student Health Center will provide counseling to students, including consideration of career options that may be best suited for the student’s disease and/or disability, regardless of insurance through GSHIP or private insurer. Depending on the student’s individual needs, a student may be referred to an occupational health, infectious disease, or disability specialist for further consultation.

Students with an infectious or environmental disease requiring medical attention are excused from training duties to seek health care (see also “Planned Health Care Appointments and Illness Policy”).

Students infected with, and in some cases exposed to, certain infectious diseases of high importance in health care settings are expected to adhere to work restrictions as detailed in Table 1 below. Students with conditions requiring testing or treatment, as outlined in Table 1, should consult with the Student Health Center or their preferred medical provider prior to returning to duty. Because student and patient well-being are of the utmost importance, failure to adhere to these work restrictions is considered a violation of the academic honor code.

Table 1: Work restrictions for medical students with infections of high importance in health care settings (modified from the CDC Personnel Health Guidelines, 1998)

Disease/problem	Work restriction	Duration
Conjunctivitis	Restricted from patient contact and contact with the patient’s environment	Until discharge ceases
Cytomegalovirus infections	No restriction	N/A
Diarrheal diseases
· Acute stage (diarrhea with other symptoms)	Restricted from patient contact, contact with the patient’s environment, or food handling	Until symptoms resolve
· Convalescent stage, Salmonella spp.	Restricted from care of high-risk patients	Until symptoms resolve; negative stool cultures may be required to return to duty
Diphtheria	Excluded from duty	Until antimicrobial therapy completed and 2 cultures obtained ≥ 24 hours apart are negative
Enteroviral infections	Restricted from care of infants, neonates, and immunocompromised patients and their environments	Until symptoms resolve
Hepatitis A	Restricted from patient contact, contact with patient’s environment, and food handling	Until 7 days after onset of jaundice
Hepatitis B	Standard precautions should always be observed; CA law does not require disclosure, but students with Hepatitis B are highly advised to seek educational and career counseling through the Student Health Center	N/A
Hepatitis C	Standard precautions should always be observed; CA law does not require disclosure, but students with Hepatitis C are highly advised to seek educational and career counseling through the Student Health Center	N/A
Herpes simplex
· Genital	No restriction	N/A
· Hands (herpetic whitlow)	Restricted from patient contact and contact with the patient’s environment	Until lesions heal
· Orofacial	Restricted from care of high-risk patients¹	Until lesions heal
Human immunodeficiency virus	Standard precautions should always be observed; CA law does not require disclosure, but students with HIV are highly advised to seek educational and career counseling through the Student Health Center	N/A
Measles
· Active	Excluded from duty	Until 7 days after the rash appears
· Postexposure (susceptible personnel)	Excluded from duty	From 5th day after 1st exposure through 21st day after last exposure and/or 4 days after rash appears
Meningococcal infections	Excluded from duty	Until 24 hours after start of effective therapy
Mumps
· Active	Excluded from duty	Until 9 days after onset of parotitis
· Postexposure (susceptible personnel)	Excluded from duty	From 12th day after 1st exposure through 26th day after last exposure or until 9 days after onset of parotitis
Pediculosis	Restricted from patient contact	Until treated and observed to be free of adult and immature lice
Pertussis
· Active	Excluded from duty	From beginning of catarrhal stage through 3^rd wk after onset of paroxysms or until 5 days after start of effective antimicrobial therapy
· Postexposure (asympto-matic personnel)	No restriction, prophylaxis recommended	N/A
· Postexposure (sympto-matic personnel)	Excluded from duty	Until 5 days after start of effective antimicrobial therapy
Rubella
· Active	Excluded from duty	Until 5 days after rash appears
· Postexposure (asympto-matic personnel)	Excluded from duty	From 7th day after 1st exposure through 21st day after last exposure
Scabies	Restricted from patient contact	Until cleared by medical evaluation
Staphylococcus aureus infection
· Active, draining skin lesions	Restricted from contact with patients and patient’s environment or food handling	Until lesions have resolved
· Carrier state	No restriction, unless personnel are epidemiologi-cally linked to transmission of the organism	N/A
Streptococcal infection, group A	Restricted from patient care, contact with patient’s environment, or food handling	Until 24 hours after adequate treatment started
Tuberculosis
· Active disease	Excluded from duty	Until proved noninfectious
· PPD converter	No restriction	N/A
Varicella
· Active	Excluded from duty	Until all lesions dry and crust
· Postexposure (susceptible personnel)	Excluded from duty	From 10th day after 1st exposure through 21^st day (28 day if VZIG given) after last exposure
Zoster
· Localized, in healthy in healthy person	Cover lesions; restricted from care of high-risk patients²	Until all lesions dry and crust
· Generalized or localized in immunosuppressed person	Restricted from patient contact	Until all lesions dry and crust
· Postexposure (Susceptible personnel)	Restricted from patient contact	From 10th day after 1st exposure through 21^st day (28^th day if VZIG given) after last exposure or, if varicella occurs, until all lesions dry and crust
Viral respiratory infections, acute febrile	Excluded from the care of high risk patients³ or contact with their environment during community outbreak of RSV and influenza	Until acute symptoms resolve

¹Those susceptible to herpes and who are at increased risk of complications of herpes, such neonates, patients with severe malnutrition, patients with severe burns or eczema, and immunocompromised patients of any age

²Those susceptible to varicella and who are at increased risk of complications of varicella, such as pregnant women, neonates, and immunocompromised persons of any age

³High-risk patients as defined by the ACIP for complications of influenza, such as pregnant women, children under 5 years old, adults 65 years of age and older, and immunocompromised patients of any age (https://www.cdc.gov/mmwr/volumes/65/rr/rr6505a1.htm)