Procedure: Infectious diseases screening and immunisation for students undertaking clinical placements in health facilities
To advise students undertaking clinical placements in health facilities of the procedures they must follow regarding screening and immunisation for specified infectious diseases and blood-borne virus testing.
Exposure prone procedure (EPP) is a procedure where there is a risk of injury to the healthcare worker resulting in exposure of the patient’s open tissues to the blood of the worker. These procedures include those where the worker’s hands (whether gloved or not) may be in contact with sharp instruments, needle tips or sharp tissues (spicules of bone or teeth) inside a patient’s open body cavity, wound or confined anatomical space where the hands or fingertips may not be completely visible at all times.
Provision and timing of information
- Students are provided with relevant information at the time the University offers a place in a program with a placement component including the immunisations required.
- Students who have a clinical placement component in their program are required to meet the requirements of the relevant clinical placement facility.
- Students provide evidence of protection against vaccine preventable diseases for assessment by the health facility in which they are undertaking their clinical placement, as required by the relevant state government. For the ACT and NSW this is outlined in the Health Staff Screening and Immunisation documents..
- Students with a medical contraindication to an immunisation provide evidence of their circumstances and contact the health facility before any clinical placement, to manage the risk of infection from the infectious diseases against which they are not protected and the consequences of infection and management in the event of an occupational risk exposure.
- Students with temporary medical contraindications for immunisation present for re-assessment after the conclusion of the contraindication or another appropriate period of time, to determine appropriate management strategies.
- Students notify the University of the nature and reasons of any restriction or qualification made to a student's activities in a clinical placement facility, including non-acceptance by a facility.
- Students take all reasonable steps to minimise the risk of transmitting infectious diseases to other students, staff, patients or other people. Where a student is infected with a blood-borne virus, they exclude themselves from the placement and contact the health facility to discuss further steps. Students infected with a blood borne virus (HIV, hepatitis C and/or hepatitis B) do not perform exposure-prone procedures without review and permission by the health facility.
- Students are skilled and compliant with health care facility procedures aimed to reduce the risk of infection transmission from patients, including standard and transmission based precautions.
- The University provides assistance to the student in accordance with its policy Disclosure of Information by Students with a Disability or Illness.
- The University discloses to a clinical placement, knowledge of any blood-borne virus or any screening and immunisation requirements not met.
- The University understands the private nature of the information that may be disclosed in a certificate and acts in accordance with the Privacy Act 1988 (Cth).
- The University will not disclose certificate information to any person outside the University, without specific written consent, except as contemplated by this policy, as required to meet legislative requirements, or unless the University considers that disclosure of the information is required to prevent or lessen a serious or imminent threat to the life, health or safety of the student concerned, or another person.
- Students who undertake a period of study overseas seek advice from an appropriate travel medicine facility to ensure they are aware of any specific health risks, obtain any relevant chemoprophylaxis and arrange payment of required and/or recommended immunisations.
- Students provide written documentation of the advice obtained to the designated program authority for each relevant program, prior to their departure for an overseas placement.
Completion of policy requirements
- Students meet the requirements set out in this policy within their first semester of enrolment.
- The University co-ordinates the collation of required evidence and identifies students who do not meet requirements, for further assessment by the health care facility.
ACT and NSW Government requirements
- Students undertaking placements or who require access in any capacity to facilities operated by ACT Health and the NSW Department of Health, are required to know their immunisation and/or infectious status throughout the period of their placement.
- Current NSW government requirements are available from http://www.health.nsw.gov.au/policies/pd/2011/pdf/PD2011_005.pdf
- Current ACT Health requirements are available from http://www.health.act.gov.au/professionals/occupational-medicine-unit
- These policies also recommend students undertaking placements be vaccinated in accordance with the recommendations of the National Health and Medical Research Council (NHMRC) as documented in The Australian Immunisation Handbook http://www.immunise.health.gov.au/internet/immunise/publishing.nsf/Content/Handbook10-home
- Students protect their patients, their colleagues and themselves from infection. Students undertaking placements in health facilities, particularly those conducting exposure-prone procedures, are inevitably exposed to infectious diseases in the course of their training. Students infected with blood-borne viruses pose a risk to patients. Many of the diseases are preventable through immunisation or by the adoption of safe-working practices.
Other placements in non-ACT and NSW jurisdictions
- Students undertaking clinical placements in non-ACT and NSW government operated health facilities, such as health facilities operated by other state and territory governments or private providers, are aware that different requirements from those set out in this policy are likely to apply.
- Students identify and comply with these requirements prior to a placement commencing and allow ample time for this process to occur.
Results of testing
- ACT Health, NSW Health or the health facility operator make the decision and outcome on immunity or infectious disease status. The University does not make decisions on immunity or infectious disease status.
- Students note that their clinical placement provider will not allow a placement at the health facility if they choose not to consent to the requirements outlined in this policy and may affect a student's ability to complete the requirements of their program.
- Students not able to complete required clinical placements during their enrolment at the University as a result of their infectious disease status will be excluded from courses requiring placements in health facilities.
- The University provides students with advice to determine their eligibility to transfer to other University programs, if required.
- Students appeal against a decision resulting from the outcome of their infectious disease status to the relevant Health Department.
- Students appeal to the Associate Dean (Education) of the relevant College if they were not informed of the requirements on infectious disease status to complete their program.
- Students appeal to the Deputy Vice-Chancellor on procedural grounds only against a decision made by the Associate Dean (Education) as per the clause above.
Specified infectious diseases
- Students provide evidence of immunisation and/or immunity for the following infectious diseases, as required by ACT and NSW Health:
- Varicella-zoster (chickenpox)
- Pertussis (whooping cough)
- Hepatitis B
- Influenza (annually and seasonal)
- Screening and assessment +/- clinical review for infection with tuberculosis is also provided.
- Students provide evidence (e.g. immunisation records and/or blood test demonstrating antibodies) according to the applicable Health Departments policy/procedure at the time of clinical placement.
Exposure prone procedures and blood borne viruses
- Students performing exposure prone procedures are tested for infection of the following viruses, as required by ACT Health:
- Human immunodeficiency virus (HIV)
- Hepatitis C virus
- Hepatitis B virus
- Students with chronic infection with either of these viruses may require further testing (e.g. hepatitis C PCR) and assessment by the relevant Health Department to determine whether they are able to participate in exposure prone procedures.
- Chronic infection may limit the ability of students to complete university training requirements and exclude health care workers from specific career options as documented in The Australian National Guidelines for the Management of Health Care Workers known to be Infected with Blood-Borne Viruses http://www.health.gov.au/internet/main/publishing.nsf/Content/cda-cdna-bloodborne.htm
Additional immunisations in special circumstances
- Students undertaking clinical or elective placements in locations with specific risks for acquisition of other infectious diseases, where immunisation is a requirement of the placement or a general recommendation for the health of the student, seek medical advice and are responsible for arrangement and payment of required/recommended immunisations. E.g laboratory placements (meningococcus), placements in Northern Australia indigenous communities (hepatitis A) and overseas placements (hepatitis A, typhoid, Japanese Encephalitis).