February 15, 2008

elevate: Answering the Tough Questions

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Medical Center leadership answers the tough questions about what the elevate program is and what it means for the people who work at VUMC.

Question: What is being done to address the number of needle sticks at Vanderbilt?

Answer: One needle stick is one too many. We devote considerable resources to the study and prevention of blood and body fluid exposures, and for more than a decade the rate of exposures has been steadily declining at VUMC.

In 2004, the most recent year for which national data are available, the nationwide health care worker exposure rate was 7.11 percent, while the rate at Vanderbilt was considerably lower, at 3.70 percent. In 2007, the annual rate at Vanderbilt had decreased to 3.57 percent.

Maintaining steady reduction in exposures requires constant vigilance, adherence to proven safety practices and continual improvement. The Occupational Health Clinic not only cares for faculty and staff who sustain an injury, but also collects detailed information on each injury, identifying high-risk devices, procedures, and jobs, and facilitating changes to make VUMC safer.

The Value Analysis Committee continually evaluates safety devices to ensure that we have the best technology available, and no new safety product comes in without the endorsement of the end user. Infection Control provides training on blood-borne pathogens and the use of safety devices. The Environment of Care Team systematically searches for any non-safety sharps and assists replacement with appropriate safety devices.

To be effective, medication to prevent HIV infection needs to start within two hours of the exposure. Occupational Health clinicians are expert at determining risk of exposure and providing appropriate treatment. After hours, the Adult ED uses the same protocols, and sends a message to OHC, which provides follow-up care.

— Melanie Swift, M.D., medical director, Occupational Health Clinic

— Valerie Thayer, R.N., occupational health specialist