Student health-care workers with cystic fibrosis: a review of recommendations for students on clinical placement

Student health-care workers (sHCW) with cystic fibrosis (CF) on clinical placement pose unique infection control issues, with potential acquisition and transmission of multi-resistant pathogens between sHCW and patients. We reviewed existing Australian infectious diseases policies and guidelines for sHCW and published data on the potential infection control risks posed by sHCW with CF in this setting. Current consensus infectious diseases guidelines for sHCW address blood-borne viruses but do not address CF, and the management of sHCW with CF is controversial. While the potential risk of nosocomial transmission of multi-resistant organisms such as Pseudomonas aeruginosa and Staphylococcus aureus, both to and from sHCW with CF is acknowledged, there have been no reports of HCW with CF-linked with outbreaks. Given the recognised risk, sHCW with CF will more than likely require modifications to their learning programs while on clinical placement to allow them to complete their studies and adequately prepare them for a range of practice in their chosen profession, while minimising risk to both patients and themselves. Universities organising clinical placement for sHCW with CF are obliged to provide vocational and academic counselling as early into the course as possible. Limited disclosure of the status of the sHCW with CF to direct clinical supervisors and infection control is essential in order to observe duty of care towards the student as well as ensuring the safety of the patients.