MONTANA STATE UNIVERSITY COLLEGE OF NURSING A-20 Procedure

Transcription

1 MONTANA STATE UNIVERSITY COLLEGE OF NURSING A-20 Procedure PROCEDURE: The MSU College of Nursing follows the procedures recommended by the Centers for Disease Control and Prevention and outlined by the Immunization Action Coalition at or Attachment A. In addition to the CDC procedures for MMR, Hepatitis B, Tdap, Varicella, and Influenza, all students and faculty are required to sign and submit the HBV Seroimmunity Status/Documentation form (Attachment C). All students and faculty without seroimmunity are required to meet with the appropriate Campus Director for counseling. Tuberculosis Students and faculty must provide a negative screening result for Tuberculosis to establish a baseline prior to clinical coursework. This will include one of the following: 1) evidence of serial Tuberculosis Skin Tests (TST) with no more than 12 months between series, 2) a two-step TST, or 3) a negative interferon gamma release assay (IGRA). Documentation of TSTs must include the dates the test was placed and read as well as the results of the test in millimeters. Students and faculty with a positive TST (depending on risk may be an induration greater than or equal to 5 mm, 10 mm, or 15 mm) will be assessed for risk and appropriately referred to their private health care provider for follow-up. Written clearance from their private health care provider will be required to participate in clinical courses. Standard Precautions All health care workers should routinely use appropriate barrier precautions to prevent skin and mucous membrane exposure when contact with blood and other body fluids of any patient/client is anticipated. For a full description of the procedures students and faculty are expected to use see the World Health Organization s Standard Precautions in Health Care (October 2007) at or facility policy. All students and faculty will complete an annual training on Standard Precautions on each campus.

2 Attachment A Immunization Recommendations

3 TABLE #1-MSU CON Immunization Requirements- Policy #A-20 REQUIREMENT PROCEDURE COMPLETION DEADLINES Tuberculosis: All nursing students are screened annually for tuberculosis (TB)* Measles Mumps Rubella (MMR): All students must provide evidence of adequate immunity via proof of prior vaccination for MMR. *If the student has had no test, or no recent test (within 2 years), a two-step skin test must be done to provide a baseline. NEW APPLICANT OR NO EVIDENCE OF ANNUAL TB TESTS past 2 years*: 1. If the student has had no test, or no recent test (within 2 years), a twostep skin test must be done to provide a baseline. STEP 1: A skin test is administered using Purified Protein Derivative (PPD) and must be read within hours. STEP 2: If the first skin test is negative, a second PPD skin test is administered within 1-3 weeks after the first one and read within hours. Students who interrupt the program of study and who are not able to produce evidence of annual testing while out ot the program, must submit the 2 STEP TESTING. CONTINUING STUDENT: The Student has provided evidence annually of TB tests while in program. 1. One PPD skin test is administered and read within hours. If the skin test is positive or converts to positive, a medical evaluation is required. This test must be completed within months of the previous annual test. STUDENTS with history of exposure to TB/BCG immunization/sensitivity to PPD Testing: 1. QuantiFERON Gold blood test (lab report required) OR T-Spot blood test (lab report required) POSITIVE TEST RESULTS TO ANY TESTING: If positive results to any of the above, the student MUST submit provider clearance documented on provider letterhead. 1. Applicants born in 1957 or later can be considered immune to Measles Mumps and Rubella (MMR) only if they have one of the following: a. Documentation of laboratory confirmation of disease b. Proof of appropriate vaccination against MMR: i. 2 doses of live measles and mumps vaccines given on or after the first birthday and separated by 28 days or more and at least one does of live rubella vaccine. NEW APPLICANTS: Upon application as a 2 step test process unless able to provide evidence of annual testing CONTINUING STUDENTS: Annually thereafter And Upon return from travel outside the US regardless of when the next annual TB test is due *Students who have interrupted their placement for any reason must either show annual tests results while out of the program, or must submit to a new two-step testing process upon return. Upon application

4 Hepatitis B (HBV): Students entering undergraduate clinical nursing course work are required to present documentation of serologic evidence of immunity (either by vaccination or previous infection, demonstrated by positive titer) to HBV. A series of three vaccinations is given over 6 months to provide immunization. A titer level is drawn 6 weeks after the last injection to document immunity. If the previously vaccinated student does not have evidence of a responsive post vaccination titer: 1. Complete a booster or challenge dose and obtain a titer post booster 2. If the student does not respond to the challenge dose, complete the series and obtain a final titer. If the student has never been immunized or exposed to Hepatitis B: 1. Complete the Hep B series and provide evidence of a positive antibody titer post vaccination (lab report required) 2. If your series is in process, provide evidence of where you are in the series to CastleBranch. Upon application Varicella: Tetanus, Diphtheria, Acellular Pertussis (Tdap) Note: If the student declines these Hep B requirements, the student must sign the Declination Waiver form. The Declination Waiver is available to download on Castle Branch from this requirement. Students are required to provide one of the following: 1. Documentation of adequate immunity through a positive varicella titer OR 2. Proof of 2 vaccinations OR 3. Medically documented history of disease (date of disease required) 4. If a student s varicella titer level is negative, the student must receive 2 doses of vaccine at an interval of 4-8 weeks between doses. 5. Post vaccination titer after 2 doses of vaccine is not necessary or recommended. One of the following is required: 1. Documentation of a Tetanus, Diphtheria & Pertussis (TDaP) vaccination from anytime AND a Td booster administered within the past 10 years OR 2. Documentation of a Tetanus, Diphtheria & Pertussis (TDaP) vaccination, administered within the past 10 years. FLU vaccine 1. Students should receive annual flu vaccination 2. If a student wishes to decline, he/she must sign a declination waiver and must comply with all clinical agency requirements during flu season as an unvaccinated person. Upon Application Upon Application Annually during flu season Students without valid documentation will not be permitted to attend clinical (will be denied access to clients).

5 Procedure #A-20 Time Lines Traditional BSN option Fall Applicant (August 1 st ) I. Fall applicants: a. Application is due by August 1 st each year b. Start Upper Division (J1) the following Fall c. Start Sophomore NRSG courses Spring semester before J1 1. Initial Immunization evidence is completed and uploaded by August 1 st when the application is due and isused to begin NRSG 225 clinicals the next Spring semester. a. The College of Nursing utilizes CastleBranch for all background checks, urine drug screens, immunization tracking, CPR verification, and E-learning compliance training b. Students must create a CastleBranch Account before turning in their applications. c. Background checks, urine drug screens, CPR verification, and E-learning must be completed at application deadline d. All Immunization status must be uploaded at application deadline Hepatitis B may be in process TB 2 step may be in process 2. 2nd Back Ground Check is completed by August 1 st and is used to begin J1 clinicals in the Fall. 3. 3rd Back Ground Check is completed by August 1 st and is used to begin S1 clinicals in the Fall. Traditional BSN option Spring Applicant (January 2 nd ) II. Spring applicants: a. Application is due by January 2 nd each year b. Start Upper Division (J1) the following Spring c. Start Sophomore NRSG courses Fall semester before J1 1. Initial Immunization evidence is completed and uploaded by January 2 nd, when the application is due and isused to begin NRSG 225 clinicals the next Fall semester. a. The College of Nursing utilizes CastleBranch for all background checks, urine drug screens, immunization tracking, CPR verification, and E-learning compliance training b. Students must create a CastleBranch Account before turning in their applications. c. Background checks, urine drug screens, CPR verification, and E-learning must be completed at application deadline d. All Immunization status must be uploaded at application deadline Hepatitis B may be in process TB 2 step may be in process 1. 2nd Back Ground Check is completed by January 2 nd and is used to begin J1 clinicals in the Spring. 2. 3rd Back Ground Check is completed by January 2 nd and is used to begin S1 clinicals in the Spring.

6 ACCELERATED OPTION BSN (ABSN) III. Annual (Fall) Application: a. Application is due by October 15 th each year b. Start the Sophomore Nursing courses the following May c. Start Upper Division in the Fall following the first block of summer course work 1. Initial Immunization evidence is to be completed and uploaded to CastleBranch by October 15 th when the application is due and is used to begin clinical and lab the next May at program start a. The College of Nursing utilizes CastleBranch for all background checks, urine drug screens, immunization tracking, CPR verification, and E-learning compliance training b. Students must create a CastleBranch Account before turning in their applications. c. Background Check, urine drug screens, CPR verification, E-learning must be completed at application deadline d. All immunization status must be uploaded at application deadline Hepatitis B may be in process TB 2 step may be in process 2. 2nd Background Check is completed by October 15 th and is used for continuing clinical compliance through graduation the following August.

7 GRADUATE STUDENTS 1. Initial Immunization verification is due by August 1 st of the first fall semester of the program of study a. The College of Nursing utilizes CastleBranch for all background checks, urine drug screens, immunization tracking, E-learning compliance training, and CPR and RNlicensure tracking b. Students must create a CastleBranch Account in order to begin the compliance screening process c. All Immunization status must be uploaded by program start Hepatitis B may be in process TB 2 step may be in process 2. Continuing graduate students will receive direction from the graduate program coordinator regarding annual compliance due dates.

8 Hepatitis B Declination Waiver STUDENT: PHONE: PLEASE INIAL THE CORRECT STATUS OF YOUR HBV TO DATE: 1) I have completed the required HBV vaccination series/final titer (according to Montana State University College of Nursing Policy A-20). Attached is documentation of my seroimmunity status. (Skip to the bottom to sign and date) 2) I have not started the required HBV vaccination series / final titer (according to Montana State University College of Nursing Policy A-20) for the following reasons: [NOTE: If for health reasons, documentation from primary care provider must be attached]. (Initial and complete #4) 3) I have not completed the HBV vaccination series / final titer (according to Montana State University College of Nursing Policy A-20) for the following reasons: [NOTE: If for health reasons, documentation from primary care provider must be attached]. (Initial and complete #4) 4) I have made the following plan to begin / complete the required HBV vaccination series / final titer to determine sero-conversion: (Initial and complete #5) 5) I understand that since I have not started/completed the required HBV vaccination series/final titer (according to Montana State University College of Nursing Policy A-20) and am unable to provide documentation of seroimmunity at this time, I am at increased risk if exposed to the Hepatitis B virus. I hereby agree to personally assume the risks involved and hereby release the college of nursing, Montana State University, its employees and agents, and any agency in which i have clinical experience of any liability should i become infected. Student Signature Date

9 Flu Declination Waiver MSU College of Nursing and affiliated clinical agencies have recommended I receive influenza vaccination to protect the patients I come into contact with during the course of my clinical rotations. I acknowledge that I am aware of the following facts: Influenza is a serious respiratory disease that kills thousands of people in the United States each year. Influenza vaccination is recommended for me and all other healthcare workers to protect this facility s patients from influenza, its complications, and death. If I contract influenza, I can shed the virus for 24 hours before influenza symptoms appear. My shedding the virus can spread influenza to patients in this facility. If I become infected with influenza, even if my symptoms are mild or non-existent, I can spread it to others and they can become seriously ill. I understand that the strains of virus that cause influenza infection change almost every year and, even if they don t change, my immunity declines over time. This is why vaccination against influenza is recommended each year. I understand that I cannot get influenza from the influenza vaccine. I understand I am required to accept responsibility for compliance with any/all clinical agencies, to which I am assigned, requirements applicable to the prevention or spread of influenza to their patient population. The consequences of my refusing to be vaccinated could have life-threatening consequences to my health and the health of those with whom I have contact, including all patients in the healthcare facility at which I engage in clinical experiences my coworkers/fellow students/faculty my family my community Despite these facts, I am choosing to decline influenza vaccination right now for the following reasons: I understand that I can change my mind at any time and accept influenza vaccination, if vaccine is still available. I have read and fully understand the information on this declination form. Signature: Date: Name (print): Upload this form to CASTLEBRANCH after signing.