Employee Health
Services
Guidelines for
Students
in
Patient Care Areas
(Information on immunizations, communicable illness and exposures)
Revised March 2009
Employee Health Services
To:
Affiliated Schools
From:
Employee Health Services
Date:
March 25, 2009
Subject:
TGH Immunizations, Exposures and Illness Requirements for Students assigned to
Patient Care Areas
Tampa General Hospital is pleased to have your students at our facilities. To provide a safe
environment and to prevent exposures to communicable diseases, we must ask that you comply with
TGH policies and procedures on immunizations and communicable illness. These guidelines also
review the procedure you need to follow if your students are exposed to a bloodborne pathogen (i.e.
needlestick) or other infectious disease (i.e. meningitis, tuberculosis).
All affiliated schools are responsible for ensuring that their students in patient care areas have
completed the required immunizations and screenings. TGH does not review documentation for
students. Each school must maintain documentation of all required immunizations/screenings for their
students.
Employee Health Services is located on the fourth floor of the East Pavilion. Take the elevators by
McDonalds to the fourth floor and follow the signs. Our hours of operation are: 7:00 a.m. to 4:30 p.m.
Monday – Friday.
Thank you for helping us keep our hospital safe for all healthcare workers, patients, and visitors. We
appreciate your cooperation. Please call JoAnn Shea, Director, Employee Health at 813-844-7692 if
you have any questions.
Employee Health Services
Tampa General Hospital
P.O. Box 1289
Tampa, FL 33601-1289
Phone: 813-844-7649
FAX: 813-844-4034
TGH Employee Health Services - 02/17/16
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Immunization Requirements
All students must complete the following requirements prior to patient contact at Tampa General Hospital.
1.
2.
Tuberculosis
a.
Documentation of a negative TB skin test (TST or QFT) within 1 year of starting clinicals/patient contact at
Tampa General Hospital.
b.
Documentation of a negative CXR (within previous 1 year) for all persons with a history of a positive TB
skin test. Students must be aware of signs/symptoms of tuberculosis.
c.
A yearly TB skin test or QFT blood test is required for all students in patient contact areas.
Rubella (German Measles)
a.
3.
All students must have documentation of rubella immunity (titer) or documentation of receipt of ONE live
rubella or MMR vaccine after 12 months of age.
Rubeola (Measles)
a.
4.
All persons must have documentation of rubeola immunity (titer) or documentation of TWO live measles,
MMR or MR vaccines after 12 months of age.
Mumps
a.
5.
6.
Chickenpox (Varicella)
a.
It is recommended but not required that students or agency/contract employees with a negative history of
chickenpox have a varicella titer drawn by their personal healthcare provider.
b.
Students with a negative history of chickenpox or a negative varicella titer must not have contact with
patients diagnosed with chickenpox or herpes zoster (shingles).
c.
The varicella vaccine (Varivax) is strongly recommended for all students with a negative varicella titer.
Hepatitis B
a.
7.
The Hepatitis B vaccine is strongly recommended for all students who may be potentially exposed to blood
or infectious body fluids. Tampa General Healthcare does not provide the Hepatitis B vaccine to students,
but recommends the Hepatitis B vaccine series be completed prior to patient contact.
Tdap (Tetanus, Diptheria, Pertussis)
a.
8.
All persons must have documentation of mumps immunity (titer) or documentation of TWO live mumps or
MMR vaccines after 12 months of age.
It is strongly recommended that students who have not had a Tetanus/Diptheria booster in the prior 5 years
receive Tdap (Adacel) prior to patient contact. Students who will have contact with patients 12 months of
age or younger should receive the Tdap vaccine if it has been at least two years since the last
Tetanus/Diptheria booster. The Tdap vaccine includes a vaccination against Pertussis.
Influenza Vaccine
a.
CDC and Joint Commission recommend that all healthcare workers, including students, be immunized
annually with the influenza (flu) vaccine.
NOTE: TGH does not review immunization records on students. Each school is responsible for complying with and
maintaining immunization documentation.
TGH Employee Health Services - 02/17/16
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Guidelines for Exposures to
Bloodborne Pathogens
TGH Employee Health Services will evaluate students and agency/contract employees who report an
exposure to blood or infectious body fluids while training or working at Tampa General Hospital. Exposures
to blood or infectious body fluids by needlesticks, sharps, mucous membrane or skin exposures should be
reported to Employee Health Services during office hours or to the TGH nursing supervisor after hours.
Please review the TGH Exposure Control Plan and TGH policies, “Management of Healthcare Workers
Exposed to Blood and Body Fluids,” and “Post-Exposure Prophylaxis After Occupational Exposure to HIV”
for specific post-exposure management information.
After an exposure to blood or body fluids, you should:
1.
Report the exposure to your instructor, supervisor or to the department supervisor where your
exposure occurred. Fill out the employee section of Tampa General Healthcare Employee Workers’
Compensation Accident Report. Have your instructor or supervisor fill out the supervisor section of
the form.
2.
During office hours (Monday-Friday from 7am to 4:30pm) report exposures to Employee Health
Services immediately. Your exposure will be evaluated and blood tests will be done to determine
your baseline HIV, HBsAb and HCV status. Employee Health will order HIV, Hepatitis B and
Hepatitis C testing on the source patient. Post-exposure prophylaxis (PEP) therapy may be
recommended if you were exposed to an HIV positive patient or a patient at risk for HIV infection.
PEP therapy is most effective if started within two hours of your exposure.
3.
After hours, report your exposure to the nursing supervisor immediately. Your exposure will be
evaluated for PEP therapy after consultation with an Infectious Disease physician. Any exposure
reported after hours must be reported to Employee Health on the next working day. ONLY Employee
Health is authorized to order HIV and Hepatitis testing on healthcare workers and source patients!!
4.
Please bring the following information on the source patient when you report to Employee Health:
source patient name, medical record number, patient ID number, diagnosis, unit, and room number.
5.
TGH will not charge you for post-exposure visits, including HIV, HBV and HCV testing or for the costs
of PEP medications. If you are seen in the TGH ER, any costs incurred through the Emergency
Room physician group will be your responsibility.
6.
Please call and Employee Health nurse practitioner at 844-4525/4526/4527 if you have any
questions concerning an exposure to blood or body fluids.
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Exposures to Infectious Diseases
Procedures students and agency/contract personnel should follow after an exposure to one of the following
infectious diseases:
1.
2.
3.
4.
Tuberculosis
a.
Confirm exposure with your instructor, supervisor or TGH department manager where the
exposure occurred.
b.
Report to TGH Employee Health Services for an evaluation if you do not have a history of a
positive tuberculin skin test (TST) or QFT.
c.
Employee Health will give you a baseline TST or QFT if you have not had a TB skin test in the
past three months.
d.
Employee Health will give you a second TST or QFT ten weeks after the tuberculosis exposure to
determine if you acquired a tuberculosis infection due to this exposure. There will be no charge
for the tuberculin skin tests.
e.
If you post-exposure TST is positive, you will be advised to report to your personal healthcare
provider for an evaluation and prophylaxis therapy.
Meningitis
a.
Confirm exposure with your instructor or supervisor and fill out a Tampa General Hospital
Employee Workers’ Compensation Accident Report.
b.
Report to TGH Employee Health Services for an evaluation of this exposure as soon as possible
(preferably within 48 hours). Prophylaxis medication may be prescribed (Rifampin or Cipro).
Chickenpox (Varicella)
a.
Persons with a negative history of chickenpox or a negative varicella titer who were exposed to
chickenpox or shingles must report to Employee Health for an evaluation.
b.
Employee Health will draw a varicella (chickenpox) titer on exposed persons (no charge). Person
with a negative varicella titer will not be allowed in patient contact areas from the 10th to 21st day
post-exposure.
Other Infectious Diseases
a.
NOTE:
Students or agency/contract personnel concerned about exposures to other infectious diseases (i.e.,
pertussis, measles, rubella, viruses, etc.) at Tampa General Hospital should call Employee Health
Services at 844-7649.
Following OSHA standards, all students and agency/contract personnel must complete a
qualitative fit test and be properly trained in the use, limitations and application of the
Tecnol PFR 95 respirator for Tuberculosis Protection prior entering the room of a patient on
airborne isolation (Tuberculosis). Each school, agency and contract individual is responsible
for ensuring the Respiratory Fit testing is completed prior to patient contact.
TGH Employee Health Services - 02/17/16
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Communicable Illnesses
Students and agency/contract personnel with an illness or medical condition that may be communicable to
patients, visitors and/or staff should not work in patient contact areas until the condition is resolved. Please refer
to TGH policy IC-23, “Work Restrictions Relating to Communicable Illness/Conditions in Healthcare Workers”
for specific restrictions.
General guidelines include:
1.
Conjunctivitis or Pink Eye: Persons cannot work in patient contact areas until the eye drainage has
ceased.
2.
Draining or infected skin lesions: Persons cannot work in patient contact areas until the infection has
resolved and/or the wound is no longer draining.
3.
Oral herpes with draining lesions: Persons cannot work in patient contact areas until the herpes lesion
is dry, without drainage.
4.
Group A streptocococcal disease (strep throat): Person cannot work in patient contact areas until 24
hours of antibiotic treatment is received.
5.
Scabies/Lice: Person cannot work until cleared by a physician or TGH Employee Health Services.
6.
Diarrhea: Person with diarrhea lasting over three days or accompanied by fever or bloody stools (or
diagnosed with Salmonella, Shigella or Giardia) cannot work in patient contact areas until cleared by a
physician or TGH Employee Health Services.
7.
Chickenpox, Measles, Mumps, Rubella, Shingles, Hepatitis A, or undiagnosed rashes: Report
measles, mumps, chickenpox, rubella or Hepatitis A cases to Employee Health immediately. Person
cannot return to patient contact areas until cleared by a physician or TGH Employee Health Services.
8.
HIV+, HbsAg+, or HCV+: Persons working in patient care areas who are positive for Hepatitis C, HIV
or Hepatitis B surface antigen may be restricted from specific exposure prone procedures. Consultation
with TGH Employee Health Services prior to patient contact is required. Strict confidentiality will be
maintained.
9.
Active Tuberculosis: Report active tuberculosis to Employee Health immediately. Persons diagnosed
with active tuberculosis will be excluded from patient care until two weeks of appropriate therapy is
completed and there are three negative sputum smears for acid fast bacilli.
We encourage you to consult with TGH Employee Health Services at 844-7649 for any potential communicable
condition. We will investigate any potential transmission to staff and patients.
TGH Employee Health Services - 02/17/16
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