Exposure to Blood & Body Fluids
Entering Orders in Wiz and
Nursing Follow-up
• Employees exposed to Blood
and Body Fluids during the
hours of 8A to 5P should go to
Occupation Health.
• Employees exposed 5P to 8A
and on weekends should be
seen in the Adult ED.
• Non Vanderbilt employees can
be treated at anytime in the ED.
Exposure to Blood and Body Fluids
is selected from the Common Clinical Problems Page.
2) When HIV status is known, select either Positive or Negative.
If HIV status is Unknown, consider all unknowns low risk
unless extenuating circumstances, ie, needle, sharp in trash or
bloody equipment in a room where an HIV patient was just discharged
1) If patient Not
Vanderbilt
employee or
student, select
Neither
If Source of exposure
is known, enter
name & MR #
If Source of exposure
Not known, enter
reason (ie, needle
in laundry)
3) Exposure Type:
Major or Minor
4) Tetanus Needed?
MD is now ready to view
recommendations based on
information collected and
treatment Protocols.
MD:
• explains recommendations
to patient
•Instructs patient that a
signed Consent is needed to
proceed if Post Exposure
Prophylaxis (PEP) is
recommended.
MD clicks patient’s Consent preference and Submits Order.
If patient refuses PEP, MD clicks (NO), then clicks “View Recommendations” again.
Recommendations include Lab tests but no Medication therapy is given when PEP refused.
A consent form must also be signed if the patient refuses PEP.
Nursing Follow-up
• Once the ordering process is complete, orders display in Orders
Tracker and Lab Requisitions print for all tests EXCEPT:
– HIV I antibody
– Hepatitis C antibody
– Hepatitis B surface antibody
– Hepatitis B core antibody
• The nurse is instructed to print various documents from e-Docs.
– Complete employee exposure requisition for tests above (print
from e-docs)
– Have patient sign “Consent /Refusal for PEP for occupational
blood/body fluid exposure and place in chart (Print from e-docs)
– Give patient “Blood/Body Fluid Exposure: Discharge
Instructions for Vanderbilt employees” (print from e-docs)
How to Find e-Docs
• From the Wiz Patient Census Screen, Click on “Web” Button
(located in lower right corner of screen).
• Click e-Docs from VUMC Resources Page
e-Docs
Type “Exposure” in Search box
View Search Results and Print
Lab Req From e-Docs for Sequestered Tests Results
Nursing Follow-up
• Collect Specimens
• Completes Wiz Requisitions
• Completes e-doc Requisition for HIV and Hepatitis Tests
• Administers PEP if ordered ONLY after Consent Form signed.
• Gives patient educational materials from e-docs.
• Instruct patient to contact Occupational Health at 936-0955 the
next business day.
If Questions regarding Ordering and Followup care of Exposure patients, contact:
• Dr. Ian Jones, Assistant Director
Emergency Department
• Dr. Melanie Swift, Director of Occupational
Health Dept.
• ED Nursing Management