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Psychiatry Residency Training Program
 
  Applicants Department GME Office Home School of Medicine UW UWHA

Residency Policies & Procedures
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XI. INFECTION CONTROL PROCEDURES, WITH SPECIAL EMPHASIS ON HEALTH CARE PROVIDERS INFECTED WITH HBV/HIV

  1. Residents shall strictly adhere to institutional policies and procedures for Infection Control.  The standard for infection control at the University of Washington Medical Center is Body Substance Isolation (BSI), and the policies and procedures are found in the relevant infection control manuals of each medical center.  The institutions will work with individuals whose compliance depends upon “modified” barrier protection.
  2. Residents are required to receive hepatitis B virus (HBV) vaccine or show proof of protection, and are encouraged to consider being tested for HIV, and other bloodborne viruses through their personal physician or alternative testing site, or at no cost through the Employee Health program.
  3. If a break in infection control technique results in the exposure of a patient to the Resident’s blood, the Resident is ethically obligated to know his or her serostatus.  In the event that s/he is HBV/HIV seropositive, the patient must be notified that a blood exposure has occurred, and offered HBV/HIV testing, counseling, and prophylaxis, where available.  Whenever possible, the anonymity, and confidentiality of the source health care provider will be protected.
  4. The University provides hepatitis B vaccine, immunizations, confidential HIV counseling, and testing, and, if appropriate, chemo-prophylaxis for occupational exposure to HIV.
  5. Health insurance, life insurance, and long-term disability (LTD) policies are available through the University for all employees, and include several optional LTD insurance plans.  Employees’ medical bills, and part of their salaries are covered by Washington State Workers’ Compensation insurance for work-related disabilities.  Additional coverage specifically for health care providers may be added as it becomes available.
  6. Certain invasive procedures are known to be associated with the risk of transmission of HBV.  Current scientific data provide insufficient documentation to determine whether these same invasive procedures may lead to transmission of HIV from an infected provider to a patient.  However, invasive procedures that have been shown to result in transmission of HBV may also result in transmission of other bloodborne viruses.  Unless scientific data demonstrate that HIV is not transmitted under the same conditions that HBV is transmitted, patients should be aware of the potential risk of transmission in these settings from a provider who is HIV seropositive.  Health care providers who are both HBV surface antigen positive (HBsAg+) and HBV e antigen positive (HBeAg+) or are HIV seropositive have a legal, and ethical obligation to conduct themselves responsibly for the protection of patients, and co-workers.  Therefore, seropositive health care providers shall not perform these exposure-prone procedures without consent from the institution, and the specific written informed consent of the patient.
  7. An advisory committee on bloodborne viruses established by the Vice President for health Sciences will be available to provide confidential consultation to HBV/HIV infected employees, and their supervisors regarding job requirements, and workplace accommodation.  Health care providers may seek counsel from this committee before choosing to disclose their HBV/HIV status to a supervisor.  A supervisor shall be responsible for defining job requirements, and providing accommodation when possible.
  8. The course of study of a trainee who is HBV surface antigen positive and HBV e antigen positive (HBeAg+) or HIV infected, and whose training would otherwise require the performance of exposure-prone procedures, shall be reviewed, according to the guidelines established in the respective Health Sciences schools, to modify or exclude performance of these procedures.  Reasonable accommodation shall be made whenever possible, and academic counseling shall be made available to trainees who alter their course of study.
  9. Confidentiality of a health care provider’s occupational exposure health status, requests for counseling or job accommodation, or modification of an academic program, shall be strictly maintained in accordance with state, and institutional guidelines.  Failure to maintain confidentiality shall be grounds for disciplinary action including dismissal.
  10. The application of policies developed from these guidelines shall reflect a case-by-case approach, taking into account the unique characteristics of each provider, and each job or course of study, and changes in the provider’s health status, and job requirements.  This document shall be revised whenever appropriate to reflect new medical, and research, findings.

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Psychiatry Residency Training Program
1959 NE Pacific Street, Box 356560
Seattle, WA 98195-6560
206-543-6577
email: psychres@u.washington.edu