Principle

Overview

In March 2021, the College of Physicians and Surgeons of Newfoundland and Labrador (CPSNL) implemented a Bloodborne Viruses Policy that is "intended to minimize the risk of exposure to bloodborne viruses for both patients and physicians during the provision of medical care".

Through possible needle sticks and other sharps-related injuries, both patients and health-care professionals may be at risk of exposure to Bloodborne Viruses (BBVs). While the risk of BBV transmission is low, the Faculty of Medicine (FoM) shares responsibility to ensure that that risk is further minimized for patients, undergraduate medical learners, and postgraduate learners.

Purpose

To outline the Faculty of Medicine’s requirements and processes regarding implementation of the CPSNL Standard of Practice: Bloodborne Viruses.

Scope

• Learners registered in the Doctor of Medicine (MD) program or a postgraduate training program in the FoM at Memorial University (Memorial). 
• Individuals applying to the MD program or a postgraduate training program in the FoM at Memorial.
• Visiting medical learners and postgraduate learners.

Definitions

Bloodborne Viruses (BBV) — As per the CPSNL Standard of Practice: Bloodborne Viruses, includes, but is not limited to, hepatitis B virus (HBV), hepatitis C virus (HCV), and human immunodeficiency virus (HIV).

Confidentiality — In the context of this policy, confidentiality refers to the manner in which information regarding serology status is treated, whether that information is provided with an expectation of privacy or not. Access to confidential records will be limited to persons authorized to access the information contained therein, except as required by law or where health, safety, or security of a person or persons is a concern.

Exposure Prone Procedures — As per the CPSNL Standard of Practice: Bloodborne Viruses, invasive procedures where there is a higher than average risk that injury to the physician may result from the exposure of the patient’s open tissues to the blood or body fluid of the physician. A further description of what procedures may be considered exposure-prone can be found in the Public Health Agency of Canada’s Guideline on the Prevention and Transmission of Bloodborne Viruses from Infected Healthcare Workers in Healthcare Settings (as amended)

An exposure prone procedure includes but is not limited to the following:

1.  Digital palpation of a needle tip in a body cavity (a hollow space within the body or one of its organs) or the simultaneous presence of the health-care worker’s fingers and a needle or other sharp instrument or object in a blind or highly confined anatomic site (i.e., during major abdominal, cardiothoracic, vaginal and/or orthopedic operations); 
2. Repair of major traumatic injuries; 
3. Manipulation, cutting, or removal of any oral or perioral tissue, including tooth structures during which blood from a health-care worker has the potential to expose the patient’s open tissue to a bloodborne virus.

Learners (UGME/PGME) — Individual currently enrolled within the undergraduate or postgraduate medical education program in the Faculty of Medicine (FoM). This also includes individuals who are accepted into a program with plans to enroll and all visiting learner(s) from another medical school.

Policy

1.0 General

1.1 The FoM endorses the CPSNL Standard of Practice: Bloodborne Viruses.

1.2 No individual shall be denied consideration of acceptance into the MD program or a postgraduate training program on the basis of their human immunodeficiency virus (HIV), hepatitis B virus (HBV) or hepatitis C virus (HCV) serological status.

1.3. An individual who is known to be serologically positive for a BBV and contemplating application to a medical education program at Memorial must seek counsel regarding their enrolment in certain postgraduate training programs. Counsel can be received from a medical doctor with expertise in BBVs or hepatology.

1.4. Evaluation for admission and/or continuation in a program will focus on whether the individual, in their current state of health, with reasonable accommodations, will be able to successfully complete the training requirements of the educational program. Such accommodations will be determined in accordance with reasonable accommodations, will be able to successfully complete the training requirements of the educational program. Such accommodations will be determined in accordance with the procedures described by the CPSNL Standard of Practice taking into consideration the training requirements.

1.5. If a Learner is seropositive for a BBV and are performing or assisting in the performance of Exposure Prone Procedures, they must notify the CPSNL Quality Assurance Committee.

1.6. All records of serology status will be kept confidential and handled in accordance with the Access to Information and Protection of Privacy Act, any other privacy legislation applicable to the University, any collective/affiliation agreement, or any CPSNL policy or procedure that may be applicable.

2.0 Responsibilities and Duties

2.1 All Learners, in the course of their training, can normally expect to assist with, or perform, Exposure Prone Procedures. Therefore, based on the CPSNL Policy, have an ethical obligation to know their serological status for BBVs.

2.2 Learners who are involved in an exposure event, such as a needle stick injury or other exposure, must seek appropriate expert advice regarding the nature and frequency of testing that is required to determine if they or others have been infected with a BBV.

2.2.1 Moonlighting, electives, global health experiences, etc. will be guided by this expectation. 

2.2.2 Financial costs associated with treatment of BBVs shall be the responsibility of the Learner. Learners are required to participate, at their own cost, in the medical plan provided through the Memorial University Student Union or a comparable plan that provides comparable coverage for treatment arising from such incidents.

2.3 Learners must sign a Declaration: Blood Borne Pathogens Serology Expectations form prior to beginning their educational program or training.

Related Documents

CPSNL Standard of Practice: Bloodborne Viruses
Student Handbook- Needle Sticks and other Health Hazards

Procedures: