Residency Policies & Procedures
XI. INFECTION CONTROL PROCEDURES, WITH SPECIAL
EMPHASIS ON HEALTH CARE PROVIDERS INFECTED WITH HBV/HIV
- 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
- 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
- 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.
- The University provides hepatitis B vaccine, immunizations, confidential
HIV counseling, and testing, and, if appropriate, chemo-prophylaxis
for occupational exposure to HIV.
- 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
- 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.
- 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.
- 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
- 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.
- 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,