Universal Precautions apply to the handling of all blood, body fluids, and human tissue. Body fluids, also known as other potentially infectious materials (OPIM), include: semen, vaginal secretions, cerebrospinal, synovial, pleural, peritoneal, pericardial, and amniotic fluids, feces, urine, sputum, nasal secretions, saliva, tears, vomitus or any other body fluid or tissue that is visibly contaminated with blood. Appropriate protection including gloves, mask and gown should be worn to protect oneself from exposure.

Should a student experience a needle stick, they are advised to call the Needlestick Hotline regardless of where the incident occurs. If immediate  emergency medical treatment is deemed necessary (sutures, x-ray, etc.), the hotline practitioner will work cooperatively with affiliated hospital to arrange this. If post-exposure prophylactic medication is necessary,  the hotline practitioner will phone in a prescription to a pharmacy convenient for the student to expedite medication administration. The hotline practitioner and student will work with the hospital personnel to attain source patient blood for testing.  In addition, students will be instructed to visit Stanford University’s Occupational Health Services at 484 Oak Road if follow-up is necessary. Any necessary testing and further treatment will be addressed at this visit and follow-up care will be arranged. Costs related to Emergency  Department care at an affiliated hospital, will be paid for by the affiliated hospital.  Costs related to the hotline usage and initial care not done at the affiliated hospital will be paid for by Stanford. The student would assume the financial responsibility for long-term care in the unlikely event that a chronic infection (e.g., HIV or hepatitis) ensues.

Students exposed to meningococcal meningitis, pertussis, or other infections that require prophylactic antibiotics are to report to Vaden Student Health Services for treatment regardless of the site where the exposure occurred.

Information about prevention, testing, and quarantining for COVD-19 are posted to the School of Medicine website (https://med.stanford.edu/eps/someducationrestart.html). Students are reminded and alerted of the policies and policy changes through email communication and town halls. Long-term policies and procedures will be developed and a strategy for disseminating the information is also in development.

Fostering a Respectful Learning Environment -Information Sheet for Reporting Concerns of Mistreatment

What is the Respectful Educator and Mistreatment Policy?

It is a policy of Stanford School of Medicine that outlines the shared commitment among all members of the SoM community to respect each person’s worth and dignity, and to contribute to a positive learning environment where medical students are enabled and encouraged to excel.

The full policy is in MD Program Handbook and Policy Manual: http://med.stanford.edu/md/mdhandbook/section-3-md-requirements-procedures/section-3-13-respectful-educatorand-mistreatment-policy.html

Where do I go to report concerns of mistreatment?

You can report concerns to the Respectful Educator and Mistreatment Committee (REMC). As a first step, please contact the chair of REMC, Rebecca Smith-Coggins, MD, at smithcog@stanford.edu or pager 13481 through the Stanford University operator, to confidentially review all options available. The purpose of the REMC is to educate and raise awareness of our standards for respectful educator conduct, to enable a procedure by which students can report concerns of student mistreatment without fear of retaliation, and to address solutions for these concerns.

You can also report to the clerkship director via phone and/or email.

• You may also utilize the hospital ‘SAFE’ reporting system if you want to report mistreatment immediately. This is on online system to report unprofessional conduct and patient safety issues:
• safe@stanfordmed.org   
• Voicemail box, (650) 497-­‐8788
• SHC connect: green box on left “SAFE”, then red box for “other”

What type of concerns should I bring to the attention of the REMC?

Any potential violations of the Respectful Educator and Mistreatment Policy, such as: 

• Public humiliation or offensive remarks 
• Threatening behavior
• Physical harm 
• Requiring a student to perform personal services (such as shopping or babysitting)
• Unwarranted exclusion from reasonable learning or professional opportunities
• Evaluating or grading on inappropriate criteria 

Harassment or discrimination on the basis of sex, race, age, color, disability, religion, sexual orientation, gender identity, national or ethnic origin.

If there is any behavior you are subjected to or that you witness that makes you uncomfortable or that you feel is inappropriate, please bring it to the RECC or report it on your clerkship evaluation.

The SoM has an Ombudsperson, James Laflin, who can be contacted at (650) 498-5744 or jlaflin@stanford.edud.edu. The Ombudsperson provides a neutral, confidential and independent resource for dispute resolution for faculty, residents, postdoctoral scholars and students.  The ombudsperson assists members of the School of Medicine community with any work-related difficulty, including interpersonal conflict or misunderstandings, as well as academic or administrative concerns.  http://med.stanford.edu/ombuds/

Providing students with a sound academic and clinical education must be carefully planned and balanced with concerns for patient safety and student well-being.

• Supervision of students

1. All patient care must be supervised by qualified residents and/or faculty.
2. Faculty, residents and students must be educated to recognize the signs of fatigue, and adopt and apply policies to prevent and counteract the potential negative effects.

• Duty hours

1. Duty hours are defined as all clinical and academic activities related to the students, i.e., patient care (both inpatient and outpatient), administrative duties related to patient care, the provision for transfer of patient care, time spent in-house during call activities, and scheduled academic activities such as conferences. Duty hours do not include reading and preparation time spent away from the duty site.
2. Students must have a minimum of 8-hours free of duty between scheduled duty periods.
3. Duty hours must be limited to 80 hours per week, averaged over a four-week period, inclusive of all in-house call activities.
4. Students must be provided with one day in seven free from all educational and clinical responsibilities, averaged over a four-week period, inclusive of call. One day is defined as one continuous 24-hour period free from all clinical, academic, and administrative activities.

• In-house call activities
• The objective of all call activities is to provide students with continuity of patient care experiences throughout a 24-hour period. In-house call is defined as those duty hours beyond the normal workday when students are required to be immediately available in the assigned institution.

1. In-house call must occur no more frequently than every third night, averaged over a four-week period.
2. Continuous on-site duty, including in-house call, must not exceed 24 consecutive hours.
3. Students must have a minimum of 14-hours free of duty after 24-hours of in-house duty.