Needle Stick/Exposures or Injury on Clinical Rotation

Procedure for Needle Stick/Exposure Incident

Students should always contact Risk Management at 623-806-7798 AZ or 630-515-6229 IL for exposures, needle sticks, or other types of injuries incurred while on clinical rotations.

Students exposed to a patient via blood or potentially infectious body fluid should:

1. Immediately cleanse the affected area in accordance with medical standards.
2. Once the patient is stable (if applicable), notify the preceptor or supervisor of the occurrence and immediately seek evaluation and treatment following established medical guidelines and the protocols of the medical facility.
3. If the facility does not provide guidelines for treatment, go promptly to an urgent care facility, medical provider’s office, or emergency room. Keep copies of all documentation.
4. Fill out injury and treatment forms following the protocol of the rotational facility or physician's office where they are assigned.
5. Students who incur expenses related to treatment of an accidental needle stick should seek reimbursement first through their health insurance company. Please note that expenses incurred due to a needle stick or injury while on clinical rotation are not covered through Worker's Compensation, unless otherwise provided by law. Any expenses that are not covered through a student's own health insurance company thereafter should be referred to Risk Management for possible assistance.

Students shall within 48 hours send a copy of the injury and treatment forms to their preceptor and clinical coordinator. When making out an injury report for an exposure incident, the student and/or preceptor should give the name of the source individual and medical record number, if known or feasible. If an exposure occurs, the following information should be recorded in the student's confidential medical record:

1. Date and time of exposure.
2. Duty being performed by student.
3. Whether protective equipment (gowns, gloves, masks, protective eyewear) or engineering controls were used (i.e., recapping device or a needle disposal device or mechanical pipette).
4. Details of exposure, including amount and type of fluid or material, and severity (e.g., depth of percutaneous exposure and whether fluid was injected, extent and duration of skin or mucous membrane contact).
5. Description of source material, including HIV, HBV, HCV status if known. In the event the source individual is a dialysis patient, a current HBsAg report should be used.

Student Consent

The consent of the student must be given, according to the directives of the rotation hospital/clinic and/or physician's office before collection of their blood and before serologic testing can be done.

Source Individual

The source individual is defined as any individual whose blood or other potentially infectious materials may be a source of exposure to the health care worker. Illinois and Arizona state statutes generally provides that “when a health care provider or employee of a health care facility is involved in an accidental direct skin or mucous membrane contact with the blood or bodily fluids of an individual which is of a nature that may transmit HIV, written informed consent of the source individual (patient) to perform an HIV test is not required.” The source individual should be identified by the student. Situations when it is not feasible to identify the source individual include incidents of needle sticks or cuts from Sharps of unknown sources, e.g., unmarked needle or blood sample. The source individual should be tested for hepatitis B, hepatitis C, and HIV in accordance with the directives of the rotation hospital/clinic or physician's office where exposure occurred.