eyes;
mouth or other mucous membranes;
non-intact skin (cracked, or abraded skin);
tissues via parenteral contact (i.e., cuts, or punctures of the skin with a contaminated needle or instrument).

The exposure must result from the performance of an employee's (student's) duties.

B. Exposure Incident Protocol

Do not dismiss the patient who is the source of potentially infectious body fluid until speaking with the nurse as the patient may need to have blood drawn.

The protocol for dealing with an exposure incident is presented as follows:

Eye or Facial Exposure: If the incident involves spatter to eyes or face, emergency eyewash stations are located in each clinical area and should be used to flush exposed eyes as soon as possible and prior to seeking additional medical care.
Parenteral Exposure: If the incident involves a potential exposure to human body fluid or materials contaminated with body substances as would occur with a needlestick or splash to mucous membranes, or non-intact skin and the exposure occurs during weekday hours both employees and students report as soon as possible to Hall Health Center. If the potential exposure to human body fluid occurs outside the above mentioned hours, report to the Emergency Room of the UWMC.

C. Post-exposure Medical Evaluation Procedure

All post-exposure medical evaluations and laboratory tests are confidential and will be provided at no charge to the employee. They will be provided by either a licensed physician or nurse practitioner in accordance with the United States Public Health Service (USPHS) recommendations. The exposed employee will be managed as shown in Tables 1 and 2. The evaluation protocol will also include the following:

Documentation of the route of exposure and related circumstances of the exposure.
The identification and documentation of the source individual (i.e., the patient), unless the University of Washington finds that the source individual's identity is not feasible, or prohibited by either state or local law.
Testing of source individual's blood (with consent) for HIV and HBV. If consent is not conveyed by the patient for testing, the documentation shall indicate the consent refusal.
Exposed employee's "evaluating physician" will be provided a copy of the results of the source individual's blood test if one is available.
The exposed employee will be informed of confidentiality of all test results by the evaluating physician. The employer (University) does not have the right to see the test results.
With the exposed employee's consent, the evaluating physician will collect blood and test for HBV and HIV. If consent is given only for collection but not testing, the physician must save the blood sample for at least 90 days in case the exposed employee should change his/her mind. When medically indicated, the exposed employee must receive an appropriate prophylaxis as recommended by the USPHS along with counseling.
An evaluation of reported illness in the immediate weeks following the exposure incident.

D. Follow-up Information

The following information will be provided to the healthcare professional who performs the post-exposure evaluation of the employee:

A copy of the OSHA Bloodborne Pathogens standard;
A description of the employee's duties as they relate to the exposure incident;
Documentation of the route of exposure and the circumstances in which the circumstances occurred as contained in the University of Washington "Incident Report";
The results of testing of the source individual's blood, if they are available; and
All medical records relevant to treatment of the exposed employee, including vaccination status, which will be maintained by the University of Washington.

It should be noted that an employee may decline, in writing, to participate in the post-exposure evaluation process.

E. Records of Injuries or Exposures

The Office of Clinical Affairs will forward injury or exposure reports to the School's Health and Safety Coordinator who will enter the report into the employee medical history record. The report should include details of the incident.
Within 15 days following completion of the evaluation, the Health and Safety Coordinator will request a written report from the evaluating physician to be stored in the medical records file. This report will include:
- documentation that the employee has been informed of the results of the tests, or evaluation; and,
- that the employee has been informed of any conditions resulting from the incident which might require further evaluation or testing.
All contents of employee medical health records are confidential.
Employee medical records shall be retained for the duration of employment plus 30 years.