You spoke, and we listened. There is now a faster, easier process for any UI employee or volunteer with a sharps injury or blood/body fluid exposure. Simply dial “STICK” or 7-8425 (319-467-8425 for external calls) to connect with an RN 24/7 who will guide you through the expedited process. No more waiting to get antiviral medication; now get the post exposure prophylaxis (PEP) within two hours of injury (the recommended standard).
The initial call must be followed by an in-person visit to the University of Iowa Employee Health Clinic on the next business day. A pilot of the new process began in the Main Operating Room June 5, with implementation house-wide June 25.
Background: Improving the process
A multidisciplinary team was formed of those involved in the current process of care including frontline staff from Employee Health, Emergency Department (ED), and the Main OR where the majority of sharps injuries occur. The team listened to residents, faculty, and nurses who shared their experiences of care. This set the stage for the change needed.
The current process for an occupational health blood/body fluid exposure includes going to the Employee Health Clinic during business hours and to the Emergency Department for after-hours and weekend/holiday care. Data showed that for either setting, the time from injury to the first dose of PEP was significantly greater than two hours. Approximately one-third of surgical residents and faculty disclosed that they had not reported a sharps injury, primarily because the process was too time consuming. The team knew that in order to meet the needs of our employees and volunteers, the process would need to be simple and efficient. After looking at many options, the team partnered with the Integrated Call Center (ICC) and Pharmacy Department to bring you a new process.
The new process uses the following steps:
- First aid to the site of injury is given as soon as possible.
- Source patient blood is drawn via Epic order for laboratory test: Post Blood/Body Fluid Exposure-Source Patient.
- Employee/volunteer calls STICK (7-8425) or 467-8425 as soon as possible.
- The RN on the call gathers information and assesses the exposure.
- If post-exposure prophylaxis (PEP) is indicated, the RN contacts Pharmacy.
- Pharmacy places order for PEP medication.
- The employee picks up PEP medication at the General Hospital Pharmacy or Iowa River Landing Pharmacy during business hours, or if after hours, the Discharge Pharmacy. The medication can be tubed to the employee if they are unable to leave work duties.
- Employee takes first dose of PEP medication within two hours of injury, while waiting for source patient blood to be resulted.
- RN phones employee/volunteer with source patient blood results when available, sets up the Employee Health Clinic appointment, and encourages the employee/volunteer to complete the incident report.
- Employee/volunteer is seen in Employee Health as soon as possible for follow-up care.
The team will continue to meet and study the new process with its utilization in our Main OR and housewide (Plan – Do – Study – Act). Any feedback on the new process is appreciated. Questions or suggestions can be directed to:
- Tammy Sebolt, interim nurse manager UI Employee Health Clinic, email@example.com or 319-356-3875
- Sarah Healy, nurse manager Integrated Call Center, firstname.lastname@example.org or 319-384-9488
- Lynnette Kenne, Operations Excellence, email@example.com or 319-467-5096
Or for more information, visit The Point, Clinical Application Web Links page, under Bloodborne Pathogen Exposures.
Special recognition goes to the committee who has and continues to work on this process improvement, which includes Brenda Carmody, Michael Edmond, Courtney Gent, Chris James, Patrick Hartley, Sarah Healy, Ashley Hinman, Stephanie Holley, Lynnette Kenne, Rashmi Mueller, Dave Nelson, Jessell Owens, Marisa Polonsky, Rhonda Price, Barb Schuessler, Tammy Sebolt, Darren Sio, Margaret Terveen, and Ken Valley.