14 April 2016
Vaccinations and tests required of incoming exchange students
Last (Family) name: ______
First name: ______
Date of birth: ______Gender:______Nationality:______
(dd/mm/yy)
Instructions for laboratory tests and specimen collection together with additional information are to be found at the end of this form.
1. MRSA
Specimen is taken from nose
Date of test: ______Result:______
(dd/mm/yy) (must be negative)
2. VRE
Specimen is taken from stool
rectum
Date of test:______Result:______
(dd/mm/yy) (must be negative )
3. Thorax X-ray
Date of X-ray:______Result:______
(Only from countries outside the EU and from Estonia, Latvia, Lithuania, Romania and Bulgaria. Statement has to be less than 3 months old; findings must be normal, do not send X-ray images)
4. Salmonella
Salmonella test results are required of (non-Scandinavian) students who will be completing practical training in delivery wards, maternity wards, neonatal wards for the newborn, maternity or prenatal clinics. A new test will be taken after arrival.
Date of test:______Result:______
5. Vaccination and immunisation information
a) Tetanus + Diphtheria vaccination Date of vaccination:______
(must be taken less than 10 years ago)
Or these vaccinations as separate:
Tetanus Date of vaccination: ______
(must be taken less than 10 years ago)
Diphtheria Date of vaccination: ______
(must be taken less than 10 years ago)
b) Polio Date of vaccination:______
c) MMR combination vaccination (measles-mumps-rubella)
= MPR combination vaccination (morbilli-parotitis-rubella)
Two vaccinations needed
Dates of vaccination ______and ______
d) Chicken pox = Varicella
Have you had chicken pox? Yes No
Have you been vaccinated against chicken pox? Yes No
Date of vaccination:______
e) Whooping cough (pertussis)
Minimum of three DTVP or DTAP vaccinations
Dates of vaccinations: 1)______2)______3)______
f) Hepatitis B vaccination
Minimum of three vaccinations
Dates of vaccinations: 1)______2)______3)______
or alternatively
A+B hepatitis vaccination
Minimum of three vaccinations
Dates of vaccinations: 1)______2)______3)______
g) Influenza vaccination (mandatory for midwifery students)
Date of vaccination:______
NB! Students who will practice at wards with children and young people have to
provide a certificate from the national criminal record
Signature of the student: ______
Name of the student:______
Date:______
Signature of the physician: ______
Name of the physician:______
Date:______
Stamp:
Instructions for specimen collection and additional information
MRSA (Methicillin-resistant Staphylococcus aureus)
11056 MRSA-Vi, MRSA colonisation specimen from the nose
The MRSA specimen is taken from the nose using a sterile cotton swab dampened in saline solution and posited in a carbon agar transport tube (Stuart tube). Tests taken abroad will be repeated in Finland before the start of the supervised training period. International coordinators will give detailed instructions concerning repeat tests.
VRE (Vancomycin-resistant Enterococcus faecalis / enterococcus faecium)
1788 VRE-Vi, VRE colonisation sample from the rectum or faeces (a cotton swab is dipped into the stool sample)
The VRE sample is taken from faeces or the rectum. The specimen is taken with a sterile cotton swab dampened in saline solution and posited in a carbon agar transport tube (Stuart tube). Tests taken abroad will be repeated in Finland before the start of the supervised training period. International coordinators will give detailed instructions concerning repeat tests.
Salmonella
Salmonella test results are required of students who will be completing practical training in delivery wards, maternity wards or neonatal wards for the newborn. Specimens will be taken from the stool sample. Salmonella tests will be repeated in Finland before the start of the supervised training period. International coordinators will give detailed instructions concerning repeat tests.