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While it is essential to ensure the rights of students at UNMC, protecting patients seeking care within the UNMC/Nebraska Medical Center system is of equal importance. The basic premise of this policy is that patients should not be exposed to bloodborne pathogens by UNMC students. The approach to students infected with bloodborne pathogens will be based upon current scientific knowledge (Henderson et. al. (2010) and guidelines from the Centers for Disease Control and Prevention (CDC) or other authoritative sources).

Policy

In compliance with the standards set forth in Section 504 of the 1973 Vocational Rehabilitation Act, UNMC

  1. does not deny admission to HIV, Hepatitis B (HBV), or Hepatitis C (HCV) -infected prospective students unless their health status prevents the completion of essential degree requirements and no reasonable accommodations can be made.
  2. does not inquire about the HIV, HBV, or HCV status of applicants during the admissions process.
  3. strongly encourages applicants who believe they may have been exposed to blood and/or other potential infectious materials to seek medical advice and HIV, HBV and HCV testing prior to admission. Such information may be relevant to the career decisions of applicants and essential to providing appropriate care to the student.
  4. will not require HIV or Hepatitis antibody testing for currently enrolled students for the purpose of obtaining a diagnosis unless they have potentially exposed a patient or personnel to their blood or body fluids.
  5. may not dismiss a student based solely upon their HIV, HBV, or HCV status.
  6. may require (at UNMC expense) that a student be tested twice a year to determine their circulating viral burden.
  7. may require a student to modify clinical behaviors based upon infectious disease best practice.
  8. may discipline a student for failure to adhere to required clinical behavior modifications. Disciplinary actions may include dismissal.
  9. may not decrease a student grade based upon the needed educational accommodations/modifications in clinical behaviors. A student may be required to take an incomplete and/or a Leave of Absence while treatment is initiated.
  10. does not tolerate harassment of known or suspected HIV or Hepatitis-infected individuals. Students participating in this form of discriminatory behavior are subject to appropriate disciplinary action.
  11. will not allow UNMC students to refuse to participate in the treatment of HIV, HBV, or HCV-infected patients during their clinical rotations. 

    Students who know they are infected are obligated to make an appointment at UNMC Student Health Services to discuss their status.

Procedures

  1. Students who know they are infected are obligated to make an appointment at UNMC Student Health Services to discuss their status as early as possible after acceptance into a program.
  2. When it becomes known that a student at UNMC is infected with a potentially transmissible bloodborne pathogen, a meeting of an Advisory Council will be called to review the student’s duties. When considering UNMC students, the Advisory Council will include the following persons: Medical Director, NMC Dept. of Infection Control & Epidemiology; Medical Director, NMC Dept. of Employee Health; Medical Director,  UNMC Student Health; Coordinator of Services for Students with Disabilities; and Dean of appropriate UNMC school or his/her designee. The Advisory Council will consider the nature of the student’s expected activities, risk factors involved, and transmissibility of infectious agents.
  3. Drawing upon consultations as needed, this council will formulate a judgment as to whether clinical training, laboratory assignments, or patient contacts should be modified in any way. Infection with a bloodborne pathogen should not require restrictions on rendering care to patients in most circumstances. However, special considerations may be appropriate when exposure-prone, invasive procedures are performed.
  4. A plan for the student’s personal healthcare, including an appropriate referral, and needed educational accommodations will be identified.
  5. HIV, HBV, and HCV-infected students are allowed to participate only in those clinical activities that do not result in risks to themselves, patients, or other students.
  6. A record of the Advisory Council’s review and recommendations will be kept in the student’s confidential file in UNMC Student Health.
  7. Cases will be reviewed periodically by the Advisory Council.
  8. The Medical Director of Student Health will inform the Dean and Academic Associate Dean of the college in which the student is enrolled to discuss any recommended educational modifications. Faculty notification will be kept to the minimum necessary in order to implement the identified educational accommodations.
  9. Information on anonymous, off-campus HIV testing sites is available from Student Health.

Henderson, D. K., Dembry, L., Fishman, N. O., Grady, C. Lundstrom, T., Palmore, T. N. et al. (2010). SHEA guideline for management of healthcare workers who are infected with Hepatitis B Virus, Hepatitis C Virus, and/or Human Immunodeficiency Virus. Infection Control and Hospital Epidemiology, 31(3), 203-232.