Clinical Rotation Health Requirements
CLINICAL ROTATION HEALTH RELATED REQUIREMENTS
According to our contractual agreements with the clinical affiliates in the community, the Center for Disease Control (CDC) Guidelines, and the policies and procedures in the Tulsa Community College catalogs and student handbooks, all students enrolling in courses that contain an assignment to patient care facilities such as hospitals, ambulatory care clinics, skilled nursing facilities and other health care settings must provide proof of immunizations (MMR, Varicella, Hepatitis B, Influenza), TB skin testing, American Heart Association CPR certification, clear background and sex offender registry checks, as well as negative drug screening. In addition, for the protection of allied health students and patients, all students must comply with the following guidelines and procedures.
The Associate Dean and/or individual Program Director may request additional health-related information and may require updates to this information if health-related requirements of clinical affiliation agreements change.
The Student Immunization Guidelines Form will guide the student in gathering and submitting the required copies of documentation to Certified Background.com, according to the attached directions, and within the timeframe specified by the Allied Health Services Program.
Students must be in compliance with immunization policies of the Allied Health Services Division and/ AHS Program in which they are enrolled. The Program Director will provide students with health requirements applicable to that program and the deadline by which students must submit proof of meeting such requirements. Students will be responsible for the costs of completion for all immunization requirements.
The following is a description of immunizations that are required and the type of documentation that a student would have to provide to verify the requirements have been met. If there is a communicable disease outbreak, additional vaccinations may be required as specified by the local public health agency. Proof of all immunizations and tuberculin skin tests should be copied and attached to the Student Immunization Tracking Form.
a)MMR (measles, mumps and rubella): students born in 1957 or later must provide proof of one of the following: written proof of two MMR immunizations OR proof of a positive titer for each of these diseases. According to CDC recommendations, students born before 1957 are generally felt to be immune, but one dose of MMR vaccine should be given to anyone born before 1957 who does not have proof of positive titers to each of the three diseases. (From Recommendations of the Immunization Action Coalition with technical content reviewed by CDC March 2007)
b)Varicella (chickenpox): two varicella vaccinations OR documented proof of previous disease completed by a licensed/certified healthcare practitioner (M.D., D.O., N.P., P.A.) OR a positive IgG titer OR if the titer is NEGATIVE obtain the first varicella vaccination and attach documentation to the Immunization Documentation form. The second varicella vaccination must be obtained 4 to 8 weeks later and proof submitted to the Program Director.
c)Hepatitis B: The Centers for Disease Control and Prevention have recommended that hepatitis B vaccine be considered for a number of groups including healthcare personnel at high risk for blood or needle stick exposure. Students will be provided with information on protective and standard precautions as part of their Program curriculum, but students are advised to consult with their personal physician about the advisability of receiving the hepatitis B Vaccine.
To meet the requirements for Hepatitis B vaccination, students must either submit proof of completion of three Hepatitis B injections OR copy of proof of a positive HbsAB antibody titer OR a signed vaccination declination form (see Exhibit B). If a student has not received injections in the past, and has not signed the declination form, he/she should receive an initial dose of hepatitis B with second and third vaccinations administered in 1 month and 6 month intervals. (Recommendations from Immunization Action Coalition with technical content reviewed by the CDC March 2007)
d)Influenza: Health care providers who are clinically or subclinically infected with influenza virus can transmit the virus to other persons including patients whose immune systems are compromised. As such, many clinical facilities are requiring that all staff, students, and volunteers show proof of an annual influenza vaccination OR a signed vaccination declination form (Exhibit B). If a student declines this immunization, and a clinical agency requires such a vaccination, there is the possibility that the student may not be permitted to participate in the clinical experience at that agency. (Recommendations of the Healthcare Infection Control Practices Advisory Committee, CDC February 24, 2006)
e)Tdap : Tetanus, diphtheria and cellular pertussis (Tdap): Proof of a one-time adult booster vaccination since 2005.
2. PPD Tuberculin Skin Testing
A two step test* may be required by the Allied Health Programs, depending on the requirements of clinical facilities. *Two-step testing is used to reduce the likelihood that a boosted reaction will be misinterpreted as a recent infection.
a)All Health Sciences students must be screened annually for TB. The typical screening test includes a single PPD skin test. Students must provide documented proof of a negative TB status every year while in the AHS Program. Vaccination with live viruses may interfere with TST reactions. For persons scheduled to receive a TST, testing should be done as follows:
• Either on the same day as vaccination with live-virus vaccine or 4-6 weeks after the administration of the live-virus vaccine
• At least one month after smallpox vaccination. (CDC, Division of Tuberculosis Elimination, June 2009).
• Students with a history of a positive reaction to TB skin tests must provide a report of a negative chest x-ray. Annual TB screenings thereafter for symptomatology will be required by a health care provider and must be submitted. (CDC, Division of Tuberculosis Elimination, June 2009).
b)Some facilities require use of the Two-Step TB Test, in which if the reaction to the first test is classified as negative, a second test is to be done 1-3 weeks later.
c) A positive reaction to the second test probably represents a boosted reaction (past infection or prior BCG vaccination). On the basis of this second test result, the person should be classified as previously infected and cared for by a health care provider. This would not be considered a skin test conversion. If the second test result is negative, the person should be classified as uninfected. In these persons, a positive reaction to any subsequent test is likely to represent new infection with M tuberculosis (skin test conversion). Two-step testing is increasingly used for the initial skin testing of adults who will be retested periodically, such as health care workers.
3. CPR Certification
Students must present a valid CPR card indicating health care provider certification which includes infant, child, adult and 1 and 2 man rescuer techniques. The certification must remain current throughout the student’s clinical experience within the program. Health Sciences students are required to obtain the American Heart Association’s BLS certification.
4. Background Checks*
All health sciences students must consent, submit to, and satisfactorily complete a criminal background investigation as a condition of participation in clinical rotations in the Allied Health Services, MLT/Phlebotomy and Nursing programs. Eligibility for participation in clinical rotations will not be final until the completion of the criminal background check with results deemed acceptable to the affiliated clinical facilities. All expenses associated with the CBC are the responsibility of the student. Students who do not consent to the required background check, refuse to provide information necessary to conduct the background check, or provide false or misleading information in regard to the background check will be subject to disciplinary action up to, and including, dismissal from the program.
Background investigations will be conducted for health sciences students prior to their initial clinical rotation, to verify identity, social security number, residency history, criminal history, sexual offender history, and to show proof that they do not appear on the Office of Inspector General (OIG) List of Excluded Individuals/Entities (LEIE) database or OFAC Terrorist List.
The student has a duty to report any action that occurs prior to or during clinical that might have an impact on his/her criminal background or OIG Exclusion List standing or OFAC Terrorist List status. In the event that a student is convicted of a felony and/or if the student is placed on the OIG Exclusion List or OFAC Terrorist List, the student must notify the Associate Dean within five (5) school days. Failure to do so may result in dismissal from the program. (*See Comprehensive Criminal Background Check Procedure)
5. Drug Screening *
All Allied Health Services students are required to submit to a pre-clinical urine drug screen according to the policy of the Allied Health Services Division. The intent of this test is to screen students for the use of illegal drug use. Illegal drugs include those drugs made illegal to possess, consume, or sell by your state and federal statutes. An illegal drug also includes those drugs taken by an individual which exceed the prescribed limits of a lawful prescription or the taking of a prescription drug without a valid prescription.
Students will receive instructions in submitting their application and paying for drug testing on-line, authorizing the contracted laboratory to perform the test. The results of the drug screen are generally accepted for the duration of the students uninterrupted enrollment in the program unless allegations are made to support reasonable cause that the student is not free of illegal drug use; with reasonable cause the student may be required to submit to further screening at his/her own expense. Tulsa Community College is responsible for designating and approving the drug screen procedures. The student must complete drug screening at the scheduled time. An unscheduled drug screen will result in an additional expense to the student conducted at a time and place designated by the college.
* Please see Health Sciences Student Drug Screening Guidance and Procedure, for a complete discussion of the drug screening requirements, consents, and academic consequences of positive results).
5a. “For Cause” Drug Screening Procedure
The information below refers to the use/misuse of, or being under the influence of: alcoholic beverages, illegal drugs or drugs which impair judgment while on duty in any health care facility, school, institution or other work location as a representative of an Allied Health Services Program.
If the clinical instructor/clinical site supervisor perceives the odor of alcohol or observes behaviors such as, but not limited to, slurred speech, unsteady gait , confusion, abnormal conduct, erratic behavior, deterioration of performance or accident while in the clinical facility, and these behaviors cause the faculty or clinical instructor to suspect the student is impaired by alcohol or drugs, the following steps are taken:
a) The instructor will remove the student from the patient care or assigned clinical work area and notify the clinical agency supervising personnel.
b) Upon student’s oral consent, the instructor will contact a family member/friend of the student or transportation service and arrange for student transport to a designated laboratory service facility. For Cause testing must occur on the same day as the observed behavior. The student will pay for all costs associated with the for-cause drug-screening test.
c) If the results of the test(s) are positive for alcohol and/or other illegal substances or for non-prescribed legal substances, the Associate Dean will withdraw the student from all didactic and clinical courses. The student may apply for re-admission to the Program following successful completion of recommended counseling and/or rehabilitation as recommended by a licensed drug/alcohol counselor.
* Please see Health Sciences Student Drug Screening Guidance and Procedure, for a complete discussion of the drug screening requirements, consents, and academic consequences of positive results.
6. Insurance requirements and responsibilities in relation to insurance.
a)Given the potential exposure to communicable disease it is highly recommended that students in Allied Health Services Programs carry health care insurance at all times while enrolled in the program. Some clinical agencies may require those students who come to that facility for clinical learning experiences to have health care insurance.
b)If a student sustains an injury while participating in any academic or clinical learning experience, they are not covered under TCC and the student will be responsible for the costs of health care treatment rendered.
c)Students are responsible for their own transportation and vehicle insurance to and from the clinical agency. No insurance coverage is provided for any vehicle not supervised and provided by the college.
d)Tulsa Community College Allied Health Services students are usually covered for acts of negligence under TCC’s general liability insurance while performing in the clinical setting as part of their Allied Health Services course work.