Adams School of Dentistry: Infection Control Manual - Chapter 04: Immunizations, Trainings, and Infectious/Communicable Disease Requirements

Introduction

Dental procedures are performed in a septic environment, posing significant hazards to both dental personnel and patients. Refer to the Infection Control Manual - Chapter 01: Introduction for an outline of risks and specific definitions. To safeguard the health and safety of ASOD personnel and the public, ASOD has established specific requirements, which includes immunizations, trainings, compliance monitoring, and post-exposure procedures.

Requirements and oversight detailed in this chapter are a collaborative effort with UNC Health Systems, as ASOD is a Community Connect partner, UNC Environment, Health, and Safety (EHS), UNC Student Campus Health, UNC Information Technology Services (ITS), UNC Institutional Privacy Office (IPO), and the ASOD Infection Control Committee.

ASOD Student vaccination requirements are reviewed biennially by the UNC Campus Health Immunization Committee, with ASOD representative(s) present. Any changes to vaccination, immunization, or communicable disease policies require review from the ASOD Infection Control Committee and/or a designated epidemiological faculty member.

Employee Training and Immunization Requirements

ASOD employees include faculty, staff, residents, affiliates, and temporary/intermittent employees. Maintenance and responsibility of collecting all relevant records belong to UNC EHS, with responsibility delegated to UNC Information Technology Services (ITS), UNC Institutional Privacy Office (IPO), and ASOD. Upon start/hire, all employees of ASOD become subject to the following enforcement of training and medical surveillance policies:

1. EHS - Chapter 01.11: EHS Management System - Enforcement of Training and Medical Surveillance
2. EHS - Chapter 06.01: Clinical Safety - Occupational Health Requirements for University Employees Located in Healthcare Facilities
3. EHS - Chapter 06 Appendix A: Required Immunization Guidelines for Certain Positions Within UNC-Chapel Hill
4. HIPAA Training Policy and Procedure
5. Information Security Controls Standard

ASOD Employee Required Trainings

Within ten (10) days of official start date, and depending on the classification of the employee, ASOD employees are required to complete the following trainings:

1. Office / Laboratory / Clinic / Environment Orientation or Student Support Services Orientation
2. ASOD Basic Life Support (course sign up is separate)
3. Bloodborne Pathogens Training
4. Tuberculosis Awareness and Infection Control
5. HIPAA Training at UNC-Chapel Hill
6. ITS Security Awareness Training
7. ASOD Medical Emergency Training
8. Respiratory Protection
9. Respiratory Protection: N-95
10. Respiratory Protection for Tuberculosis and Infectious Diseases
11. Radiation Safety for UNC School of Dentistry X-Ray Equipment Operators
12. HazCom 2012 Global Harmonization System
13. Vendor Relations for Adams School of Dentistry
14. Joint Commission and Emergency Preparedness Refresher for the Clinic Environment

ASOD Employee Required Immunizations

The University Employee Occupational Health Clinic (UEOHC) provides pre-employment screening, annual immunization reviews, and medical surveillance for all UNC healthcare employees. While dependent upon the role, all ASOD employees are required to have annual immunization reviews. If a new clinical employee is not automatically enrolled in the Immunization Review process, or an employee has transferred to a clinical role, contact ASOD HR at sod_hr@unc.edu and request the employee be added to the Immunization Review program via the ePar system.

1. Hepatitis B
   • Offered for free by UEOHC, unless contraindications;
   • Immunity to hepatitis B virus is strongly encouraged for all employees;
   • Laboratory evidence of immunity;
   • Prior receipt of 2 or 3 doses of vaccine, with appropriate schedule;
   • Signed OSHA declination.
2. Tuberculosis (TST/PPD)
   • 2-Step TST or Serological Titer;
   • Annual TB Immunity Questionnaire.
3. Influenza Vaccine
   • Annual requirement starting 08/01 with deadline of 10/31 each year;
   • Entered via EHS Flu Certification Application, if applicable;
   • Declination via Medical Contraindications Certification or Religious Declination Certifications;
   • Medical Contraindications Certification or Religious Declination Certifications submitted;
   • Information on specific locations available via https://flu.unc.edu/.
4. COVID-19
   • Strongly recommended CDC "up-to-date" vaccinations;
   • Report received vaccinations.

Student Training and Immunization Requirements

Immunization requirement for all students enrolled in ASOD are outlined in the New Learner Compliance Checklist, found in Connect Carolina, and available during matriculation. Checklist models Campus Health's Immunization for Health Science Students webpage, with additional trainings. All students are required to complete and provide documentation before the completion of their respective orientation course. Definitions of mandatory health, safety, and legal requirements of all Doctor of Dental Surgery (DDS) and Dental Hygiene (DH) are listed within the ASOD: Policy on DDS and DH Student Programs Compliance.

ASOD Student Required Trainings

Within the orientation period of each respective program (30 days maximum), the following trainings are required, with documenting proof of completion via the ASOD Compliance Portal:

1.  HIPAA Training at UNC-Chapel Hill
2. ITS Security Awareness Training
3. ASOD Medical Emergency Training
4. ASOD Basic Life Support (course sign up is separate)
5. Tuberculosis training (integrated into the curriculum)

ASOD Student Required Immunizations

Prior to entry into any ASOD program, the following immunizations must be completed or scheduled for completion. All documentation is entered into both Connect Carolina and ASOD Compliance Portal:

1. Hepatitis B
   • 2 or 3 dose series required;
   • AND quantitative titer required.
2. Tetanus, Diphtheria, Pertussis (Tdap/TD)
   • 3 dose series required;
   • AND minimum 1 Tdap booster within past 10 years.
3. Varicella
   • 2 dose series;
   • OR serological titer demonstrating immunity.
4. Measles, Mumps, Rubella (MMR)
   • 2 dose series.
5. Tuberculin Screening
   • Serologic test preferred (recommended T-SPOT.TB or QuantiFERON Gold Plus);
   • OR 2-Step TST.
6. Influenza Vaccination
   • Annual requirement starting 08/01 with deadline of 10/31 each year;
   • Upload proof to ASOD Compliance Portal;
   • Medical or religious exemptions reviewed by Campus Health and student submitted to ASOD Compliance Portal.
7. COVID-19
   • Strongly recommended CDC "up-to-date" vaccinations;
   • AND EITHER:
     •  Documentation of previous vaccination;
     • Intent to request exemption

Infectious Agent Transmission - HBV, HCV, and/or HIV-Infected Healthcare Professionals

Applicable to all ASOD personnel and students, Chapter 06.07: Clinical Safety - Healthcare Personnel Who Are Infected With Hepatitis B Virus, Hepatitis C Virus, and/or Human Immunodeficiency Virus from UNC EHS outlines the policy and procedure, related to reporting if a healthcare professional is currently or becomes aware that they are infected with HBV, HCV, and/or HIV. Summarizing, any clinician who pose a risk of transmitting an infectious agent must consult with the appropriate healthcare professionals, to determine whether continuing to provide professional services represents a material risk to patients or other healthcare workers. Per UNC Health Infection Prevention and Screening Program: Occupational Health Service (requires Epic login to access), the appropriate reporting facility for ASOD employees is UNC University Employee Occupational Health Clinic (UEOHC), with ASOD students reporting to UNC Campus Health. If either UEOHC or UNC Campus Health decide that continuing to provide professional services represents a material risk to patients or co-workers, the ASOD personnel member or student must inform the Dean of Adams School of Dentistry. Once informed, the Dean will take such action as necessary to protect against the transmission of infection to others. ASOD will protect the privacy and confidentiality of any and all associated test results.

Additional reporting procedures may be required, depending on the situation. Review Chapter 06.07: Clinical Safety - Healthcare Personnel Who Are Infected With Hepatitis B Virus, Hepatitis C Virus, and/or Human Immunodeficiency Virus for full details.

Bloodborne Pathogens Policy Statement and Summary

The safety and health of our healthcare personnel and students are of utmost importance. UNC ASOD is committed to providing a safe educational and working environment, which is why UNC ASOD recognizes the potential hazards posed by exposure to bloodborne pathogens (BBP) and other potentially infectious materials (OPIM), as outlined in the Infection Control Manual - Chapter 01: Introduction.

1. Education and Training
   • All ASOD personnel and students will receive training on BBP standards, risks of exposure, and preventative strategies. Full outline of provided trainings is listed earlier in this policy (Infection Control Manual - Chapter 04: Immunizations, Trainings, and Infectious/Communicable Disease Requirements).
2. Prevention
   • Standard precautions are to be followed, to safely handle BBP and OPIM. Definition of Standard Precautions can be reviewed in the Infection Control Manual - Chapter 02: Program Administration & Methods of Implementation.
3. Personal Protective Equipment (PPE)
   • Appropriate PPE will be provided to ASOD clinical personnel and students, which must be utilized when there is a potential for exposure to BBP or OPIM. Full details can be reviewed in the Infection Control Manual - Chapter 07: Personal Protective Equipment (PPE).
4. Exposure to BBP or OPIM
   • In the event of an exposure incident, the exposed individual must stop treatment immediately, wash the injured area with soap and water, inform a supervisor/instructor, and submit an Incident Report. Review the Incident Report, Documentation, & Corrections Procedure and Procedure Following Bloodborne Pathogens Exposure for specific details.
5. Post Exposure Evaluation and Follow Up
   • Following the reporting of the exposure incident, Campus Health, UEOHC, or the external clinical site will provide an evaluation and follow up care, as outlined in the Exposure Control Plan for Bloodborne Pathogens (requires Epic login to access).

Relevant Policies

1. UNC-Chapel Hill Health: Exposure Control Plan for Bloodborne Pathogens
2. UNC-Chapel Hill Health: Exposure to Communicable Disease
3. UNC-Chapel Hill Health: Infection Prevention and Screening Program: Occupational Health Service
4. UNC-Chapel Hill Health: COVID-19 Control Plan
5. UNC EHS: Chapter 01.11: EHS Management System - Enforcement of Training and Medical Surveillance
6. UNC EHS: Chapter 06.01: Clinical Safety - Occupational Health Requirements for University Employees Located in Healthcare Facilities
7. UNC EHS: Chapter 06 Appendix A: Required Immunization Guidelines for Certain Positions Within UNC-Chapel Hill
8. UNC EHS: Chapter 06.07: Clinical Safety - Healthcare Personnel Who Are Infected With Hepatitis B Virus, Hepatitis C Virus, and/or Human Immunodeficiency Virus
9. Privacy Office: HIPAA Training Policy and Procedure
10. UNC ITS: Information Security Controls Standard
11. ASOD: Policy on DDS and DH Student Programs Compliance
12. ASOD: Basic Life Support (BLS) Certification Policy
13. ASOD: Policy for Management of Medical Emergencies
14. ASOD: Procedure Following Bloodborne Pathogens Exposure
15. ASOD: Infection Control Manual - Chapter 03: Incident Reporting
16. ASOD: Incident Report, Documentation, & Corrections

Back to Chapter 03

Proceed to Chapter 05