After your FMLA papers have been processed, Human Resources will notify your supervisor by e-mail and then your supervisor or manager will notify you. Housestaff and faculty are notified by their Program Director or Dean. Please allow 5 work days from receipt of the medical certification from your healthcare provider.
You can check your compliance in the Health and Wellness Information Portal. Your supervisor can view your compliance status using the "Record Of Compliance in Occupational Health Clinic" report in the BI Launch Pad. Also, you can call the Occupational Health Clinic during business hours and select the phone menu options for "compliance questions."
You may see the date of your last TB skin test by logging in to the Health and Wellness Information Portal.
Physicians, Nurse Practitioners, and Occupational Health Clinic staff may read results. Also nurses who have been trained and certified by Occupational Health Clinic can read the results. You cannot read your own TB skin test.
If there is either redness or swelling at the TB skin test site at 48 hours you must come to the Occupational Health Clinic to have the test site evaluated. If more than 72 hours has passed since the test placement you will need to have a new test placed so that the reading can be confirmed by the Occupational Health Clinic staff.
When a person has a negative TB skin test reaction, giving a second test two weeks later can confirm that person is truly negative. The first test serves to "boost" the immune system so it responds fully to the second test. This two-step testing identifies persons who were exposed to tuberculosis many years prior and did not receive routine testing.
Some people who are immunosuppressed cannot mount a full immune response to a skin test. For this reason the criteria for interpreting a test as positive differs depending upon the immune status of the individual. An immunosuppressed patient with induration (swelling) of just 5 mm would be considered positive, and this would be very valuable information for them to know. Since the skin test is not harmful for these patients, we do not exclude immunosuppressed employees from this important surveillance program which is designed to protect them. While OHC will accept a record of a blood test for TB infection (an IGRA such as T-Spot or QuantiFERON-Gold) in lieu of skin testing, we cannot reimburse for the cost of blood testing, since skin testing is not medically contraindicated.
The skin test medication, called PPD, is a pregnancy category B medication, which means that animal reproduction studies have not demonstrated a risk to the fetus and there are no adequate and well-controlled studies in pregnant women. The CDC supports testing of pregnant healthcare workers who are in occupational TB surveillance programs, and the Vanderbilt Medical Center policy specifically states that pregnancy is not a valid reason for medical deferral from the surveillance testing program. This policy was drafted with input from the Vanderbilt Department of Obstetrics and Gynecology which fully supports this position. While OHC will accept a record of a blood test for TB infection (an IGRA such as T-Spot or QuantiFERON-Gold) in lieu of skin testing, we cannot reimburse for the cost of blood testing, since skin testing is not medically contraindicated.
Notify your supervisor and complete a First Report of Work Injury. If you need medical care, proceed to the Occupational Health Clinic. After business hours, go to the Vanderbilt Adult Emergency Department.
Risk Management determines if the condition is compensable under TN Workers' Compensation. You can be seen in Occupational Health for an initial consultation regardless of the Workers' Compensation decision.
There are no charges for professional services at Occupational Health Clinic.
However, lab tests and/or medical supplies for non-work-related conditions will incur charges, which are the patient's responsibility. Typically, diagnostic tests ordered in Occupational Health are not covered by health insurance.
Walk-in services are available for vaccines, labs, TB tests and urgent medical care. Walk-in services are also available for minor medical conditions at Faculty/Staff Express Care.
We do not close for lunch; however, depending on clinic volume, walk-ins may experience a longer wait during the lunch hour.
It is extremely important to order the source labs quickly. Medication to prevent HIV is most effective if given within 2 hours of the exposure, so the source patient's HIV status must be ascertained right away.
If you have access to eStar, find the source patient order set by typing in exposure or source or blood in the order/order set field. You should see and select the "Source Blood/Body Fluid Exposure Panel". The ordering provider will be the patient's attending provider.
If you cannot find the order set, please order the following labs from the Facility List:
- "Rapid HIV BBF Exposure"
- "PCR Hepatitis C Virus Qt"
- "Hepatitis B Surface Ag"
If you will be using an external lab, contact the Occupational Health Clinic at 615-936-0955 for assistance. Recorded instructions for providers and exposed employees is also available by calling 615-875-STIK (875-7845.)
For non-occupational testing, you can bring a completed requisition from your Vanderbilt Provider ordering the test. We can draw the blood for you and send it to the Vanderbilt lab for testing. The Vanderbilt lab does not accept lab orders from providers outside VUMC. The provider must include the ICD-10 code with the order. We do not charge you for the visit, and the lab will bill your insurance.
Most vaccines are safe while breastfeeding. Live virus vaccines should be avoided in pregnancy but are generally OK while breastfeeding. For more information, please visit the CDC website which lists all common adult vaccines and safety information.