Occupational Health and Infectious Diseases: Preclinical Placement Requirements for Pharmacy Students

Transcription

1 Occupational Health and Infectious Diseases: Preclinical Placement Requirements for Pharmacy Students This document outlines immunization and other occupational health requirements that pharmacy students need before they begin any clinical placement in a health facility through the course of their health professional program. Health Canada in their guideline Prevention and Control of Occupational s in Health Care use the term health care worker (HCW) to include any individual who has the potential to acquire or transmit infectious agents during the course of his or her work in health care and includes students and researchers 1. The medical literature and our own workplace experience documents the potential for health care workers to acquire infections, both in and outside the workplace, and for them to transmit infection to patients, co-workers, and family members 2-4. These infections may be spread through the airborne route (e.g. tuberculosis, varicella, measles), droplets (e.g. respiratory syncytial virus, influenza, rubella, pertussis), contact (e.g. hepatitis A, group A streptococcus), and mucosal or percutaneous exposure (e.g. hepatitis B and C, HIV) 5. Several of these infections are vaccine preventable. Most of these vaccine preventable infections may be transmitted from person-to-person. With that in mind, both the Steering Committee on Control Guidelines and the National Advisory Committee on Immunization have provided recommendations for health care worker immunization 1,6. Based on these and other guidelines 1,6,7, Capital District Health Authority, IWK Health Centre, and Dalhousie University Faculties of Dentistry, Health Professions, and Medicine have developed the following policy for infectious diseases. The following infectious diseases and immunization checklist is to be completed by a physician or public health official prior to your commencement of clinical work at Dalhousie University. It might be best to have all of your immunizations up-to-date before you begin your program as some immunization schedules take several months to complete. 1. Health Canada. Prevention and control of occupational infections in health care. CCDR 2002;28S1. 2. Sepkowitz KA. Occupationally acquired infections in health care workers. Part 1. Ann Intern Med 1996;125: Sepkowitz KA. Occupationally acquired infections in health care workers. Part II. Ann Intern Med 1996;125: Patterson WB, Craven DE, Schwartz DA, Nardell EA, Kasmer J, Noble J. Occupation hazards to hospital personnel. Ann Intern Med 1985;102: Health Canada. Routine practices and additional precautions for preventing the transmission of infection in health care. CCDR 1999;25S4. 6. Health Canada. Canadian Immunization Guide. Canadian Medical Association 2002 (6 th edition). Ottawa, ON. 7. Health Canada. Guidelines for preventing the transmission of tuberculosis in Canadian health care facilities. 8. and other institutional settings. CCDR 1996;22S1. Page 1 of 5

2 Dalhousie University College of Pharmacy students must submit a completed copy of the following immunization record and tuberculosis screening forms. Students should keep the original records and forms as they may need the originals in the future when they begin work as a pharmacist. The completion of these forms is mandatory for all students enrolled at the College of Pharmacy. Immunization records must be complete prior to starting practice experience program courses. Practice sites may ask students to complete additional health screenings and/or immunizations. This immunization policy may be updated from time to time and students will be notified via PharmX the College of Pharmacy intranet tool. Incomplete immunization records can delay or cancel practice experience course work. CLASS OF 2016 IMMUNIZATION FORMS FOR PHARMACY 2081/2082 COURSES ARE DUE NO LATER THAN: Friday, January 10, 2014 Immunization records must be complete and on file to receive a 2 nd year Pharmacy 2081 Hospital Rotation Match and to receive final approval for your Pharmacy 2082 Community Rotation site for your required clinical rotation courses during the Summer of These courses are required to be successfully completed in order to enter 3 rd year Pharmacy. Questions about the College of Pharmacy immunization policy should be directed to: Harriet Davies Coordinator of Clinical Education Tel: Fax: hdavies@dal.ca -Page 2-

3 Vaccine preventable infection Requirements/indications Vaccination Results* (immune/ non-immune) Diphtheriatetanus-pertussis (TdaP) Will have a complete primary series of 3 doses of a combined tetanus, pertussis, and diphtheria preparation and booster within the last 10 years unless contraindicated. For adults who have not had a dose of acellular vaccine, a Td booster could be replaced by the TdaP vaccine. For MMR: record of two MMR vaccines is required or titres for measles, mumps and rubella showing immunity Measles (Rubeola) Two documented doses of MMR vaccine are required for those students born after MMR #1 MMR#2 Mumps In the past several years, there have been significant outbreaks of measles and mumps across Canada. Most people born between 1970 and 1994 received one dose of the MMR vaccine at age 12 months. Health Canada has identified that this one dose is not sufficient to provide life long immunity in a majority of people. Rubella If born prior to 1970, please provide written confirmation and laboratory evidence of having had measles, mumps and rubella disease(s). Please attach results of titres. Page 3 of 5

4 Vaccine preventable infection Requirements/indications Vaccination Results* (immune/ non-immune) Hepatitis B Consider immune with evidence of 3 doses of HBV-containing vaccine given at 0, 1, and 6 months AND one documented adequate anti-hbs titre done 1-6 months post immunization; or anti-hbs positive, anti- HBc positive, or HbsAg positive from hepatitis B infection. If nonimmune requires 3 doses of HBV-containing vaccine given at 0, 1, and 6 months unless contraindicated with anti-hbs testing done 1-6 months after the 3 rd dose. Individuals testing anti-hbs negative several years after receiving the primary series may receive one booster followed by post-vaccine serology to determine responder status. Nonresponders should be immunized with a second 3-dose series unless contraindicated and serologic testing repeated. Non-responders may require testing for HbsAg. Titres are required please attach copy of results Varicella (Chicken Pox) Consider immune with evidence of self reported history of varicella or shingles, or physician-diagnosed varicella or shingles or documentation of VZV IgG or 1 dose (if given before age 13 years) or 2 doses given at least 1 month apart (if given 13 years age) of live varicella vaccine. If non-immune requires 2 doses of live varicella vaccine at least 1 month apart unless contraindicated. Influenza It is recommended that students be immunized against influenza on an annual basis. *if available, copy of an official immunization record or lab results should be attached for proof of immunization Signature of Health Care Professional Date: DD/ MM/ YYYY Please print name: -Page 4-

5 Tuberculosis Screening BCG Year Received Yes No Year Notes Tuberculosis BCG vaccine is no longer recommended. Students must submit a record of a two-step Mantoux completed within the last 2 years. I. Tuberculin skin test (TST) date read: / / Step-I of two-step Result: mm II. Tuberculin skin test (TST) date read: / / Step-II of two-step Result: mm If there is a documented prior positive TST, previous treatment for active TB, or previous treatment for latent TB, a TST is not required. Medical evaluation and a chest X-ray within 1 year (if asymptomatic) are required. Chest X-ray* date: / / *attach photocopy of Chest X-ray report Signature of Health Care Professional Date: DD/ MM/ YYYY Please print name: Page 5 of 5