Thursday, November 5, 2015

I Can’t Afford To Be Sick!

“I can’t afford to be sick right now” is a common complaint at Student Health.  Test week, presentations, finals, and interviews are all highly inconvenient times to be sick.  You want to feel better, and we want you to feel better, but antibiotics are not always the answer. 

Pathogenic microorganisms, or microbes that cause infection and disease are growing stronger and more resistant to treatment for a number of reasons.  Microbes are little critters that multiply rapidly, so they are able to adapt quickly to new environmental conditions.  If a gene mutation occurs which allows a certain organism to survive, it will soon become dominant.   Scientists believe that microbes can transfer genes to one another, allowing them to work as a team against us.  So microorganisms have some advantages, but as humans, we are doing quite a bit to aid the enemy.
Inappropriate use of antibiotics, misdiagnosis, agricultural use and inadequate infection control are all human behaviors that encourage microbes to mutate and become resistant to medication.  Much of this is out of your personal control, but there are a few important things you can do:

·         Always finish your prescription, unless otherwise advised by your healthcare provider.  If you stop taking your medication as soon as you feel better, the stronger microbes may still be alive and kicking, ready to launch a counter-attack that may not be responsive to the same medication.

·         If you finish your prescription, you won’t be tempted to use leftover medication the next time you’re sick which is another common mistake.  You also won’t be tempted to share your leftover medication with a friend.

·         Don't insist on an antibiotic if your healthcare provider tells you that your illness is caused by a virus.  An antibiotic will not make you feel any better, and you are setting yourself up for side effects and complications down the road.

·         If an antibiotic is prescribed, ask your provider if tests will be done to ensure you are getting the right one.

·         Do your part to prevent infections with good hygiene and recommended vaccinations.

Clinical trials are underway to help us combat microbial resistance.  Of course, developing new antimicrobial therapies is an important and ongoing focus.  Research also helps us find the best ways to use our existing drugs.  Researchers are also testing products that help prevent infections in the first place. 

This is not a war we can afford to lose.  Please do your part to keep resistance from becoming a bigger problem and spread the word so others can join in the effort. 

My name is Jennifer Blanck, RN, and I am always happy to hear from students and help in any way I can. Feel free to give me a call if you have any questions regarding your requirements. My direct line is 913-588-2018.

Monday, August 3, 2015

A Student's Guide to TB Testing

“Why do KUMC Students have to have annual TB screening?”  That’s a common question at Student Health.  Most employers require TB screening every two years at most.  Doesn’t it make sense that Student Health would do the same?

Student Health requirements are determined by a couple of different sources.  The Kansas Legislature requires all students to complete TB testing before entering the classroom.  In addition, KUMC has contractual agreements with clinical settings in which we guarantee that our students are screened for TB on an annual basis. 
So what are your TB testing options?  Students who are classified as non-clinical may complete their annual requirement with a risk screening questionnaire after their enrollment TB testing is complete.  All clinical students are required to have an annual TB test.  If you’re a clinical student, there are a few ways to complete the TB test requirement:

·         TB skin test.  This test is available at Student Health, free of charge.  A small amount of purified protein derivative (ppd) is placed under the skin in the forearm.  In 48 – 72 hours, the student returns to Student Health so that the forearm can be assessed.  If there is no reaction at the test site, the test is negative.

·         Students who have not had a skin test within the past year will have to complete a two-step skin test.  That means that a TB skin test is placed and read.  In the next week or two, another TB skin test is placed and read.   The two-step test is required initially and can be followed by a one-step test annually thereafter.

·         Student Health will accept TB skin tests from outside clinics, however any skin test that is placed at Student Health must be read at Student Health. 

·         Another way to fulfill the TB test requirement is through a blood test called “Quantiferon Gold” or QFT.  The QFT is offered at Student Health, but it is not free of charge.  The fee for the QFT is $65 for students who pay out-of-pocket.  If a student carries the United Healthcare Student Resources insurance policy, the QFT is covered and there is no fee.  A student with private insurance such as Blue Cross/Blue Shield may ask that the test be submitted to insurance, however there is no guarantee that it will be covered.  We strongly recommend that you call your insurance company prior to the test to verify coverage.  If the test is not covered, your bill will be significantly more than $65.   An advantage to completing the QFT over the skin test is that it can be done in one visit.  Also, if a QFT is done, the two-step TB test is not required.

What happens if a TB test is positive?  If a TB test is positive, a chest x-ray is required, along with a visit with a provider to discuss the possibility of latent TB and antibiotic treatment.
As always, I am happy to discuss your individual TB situation with you, or answer questions.  Give me a call at 913-588-2018.

My name is Jennifer Blanck, RN, and I am always happy to hear from students and help in any way I can. Feel free to give me a call if you have any questions regarding your requirements. My direct line is 913-588-2018.

Tuesday, July 7, 2015

I've been stuck by a dirty needle -- now what?

Have you ever wondered what happens when you get a needle stick?  You know you’re supposed to report to Student Health immediately, but then what?

When a student comes in with a needle stick or exposure to a patient’s blood or body fluids, we kick in to action. 

First we go to the patient room and draw blood from your source patient.  ("Source Patient" is what we call the person who was the source of blood or body fluids to which you have been exposed.)  Right away that blood goes to the KU lab and is tested for HIV.  Normally we know within an hour whether the source patient is infected with HIV.  That’s important because you would need to start medication within a certain number of hours to prevent HIV.  As soon as we know whether your source patient has HIV, we call you and let you know.  

Your source patient will also be tested for Hepatitis B and C, but those tests are not done stat and will usually come back the next day.

Next, we talk to you about the exposure incident.  We fill out confidential, anonymous paperwork with details of how you came in to contact with a patient’s blood or body fluid.  The paperwork is used to compile a report that is sent to the hospital so that future needle sticks or exposures might be prevented.  We will ask you if you have any suggestions about how your exposure could have been prevented.  This protects other students and healthcare providers in the future.  Sometimes there’s no obvious way that the exposure could have been prevented.  That’s OK.  If the reports reveal a pattern, that’s helpful too.

After we complete the paperwork, your blood is drawn to determine your baseline.  You are tested for HIV and Hepatitis C.  If we don’t have proof of your immunity to Hepatitis B, you are tested for that also.  When you come to Student Health right away, it is too early for your blood to be affected by a needle stick or other exposure, that’s why your blood work serves as a baseline.     

We want you to know that your name is not reported.  All your lab work is sent in anonymously.  I’ve had students worry that they might be punished or dismissed from school because of a needle stick or exposure.  That is never the case. 

It’s also important to know that you will not be charged for any of the costs associated with the needle stick.  Needle sticks or exposures are relatively common events, and your program of study expects to pay for a certain number of events throughout the year.    

I hope you never have a needle-stick or splash, but if you do, come to Student Health right away so you can be assured of the proper follow up.

My name is Jennifer Blanck, RN, and I am always happy to hear from students and help in any way I can. Feel free to give me a call if you have any questions regarding your requirements. My direct line is 913-588-2018.


Wednesday, May 27, 2015

How to Avoid a Student Health Hold

 It’s the first day to enroll.  You’ve planned and plotted to get the perfect schedule.  Classes are filling up fast… and you find out you can’t enroll because of a Student Health hold!  Suddenly your perfect plan deflates like a sad party balloon.

It doesn’t have to be this way.  Did you know you can view your immunization record online to see if you are up to date with your requirements?  Log on to the KUMC Central Authentication Service with your usual KUMC ID and password.  You’ll be asked to enter your date of birth as an extra security measure.  Once you submit your consent and privacy forms, you can simply click “Immunizations” to see your record.  If any requirement has a red “x” beside it, it is missing or expired.
Student Health will send regular notifications via secure message if you have missing or expired requirements.  We make every effort to notify you before a hold is placed.  In fact, most holds are placed on students who have not read their secure messages, (yes, we can see if you have read your message or not!)  So if you receive a message with the subject line, “IMPORTANT MESSAGE FROM STUDENT HEALTH, COUNSELING, EDUCATIONAL SUPPORT, OR ACCOMMODATIONS SERVICES” you should read it right away. 

New students have an automatic hold before classes begin to ensure that all health requirements are met.  If you are a new student, you can view your list of requirements by visiting this page on the Student Health website.  Follow the instructions to submit your health requirements.  It is never too early to send in your documents so that your hold can be released.
My name is Jennifer Blanck, RN, and I am always happy to hear from students and help in any way I can.  Feel free to give me a call if you have any questions regarding your requirements.  My direct line is 913-588-2018.   

Got titers?

Remember that feeling of exhilaration when you received your letter of acceptance to KUMC?  That wonderful feeling may have been short-lived when you saw all the requirements that were due before stepping foot on campus! 

Many students at KUMC are required to submit titers as part of their enrollment paperwork.  But what is a titer, anyway?  And why are titers required at KUMC?  You probably never needed them for any other school.

Titers are important blood tests that tell us whether you are immune to certain diseases.  Most people who received their childhood vaccinations will be immune to Measles, Mumps and Rubella.  Hepatitis B and Chicken Pox are a little less certain because not everyone has been vaccinated or has had Chicken Pox Disease. 

Many students at KUMC work with patients through clinical activities.  Titers as proof of immunity become important in a couple of situations.  If a patient has a communicable disease such as chicken pox, we know you are safe to work with that patient if your blood work shows that you are immune. Other situations may arise, such as the recent measles outbreak.  Students who have proven immunity to measles are allowed to continue clinical work without concern that they may contract or spread the disease.

Hepatitis B immunity is important because that disease is spread through contact with blood or body fluids from an infected person.  As a clinical student, it is not uncommon to come in contact with blood or body fluids through a needle-stick or a splash.  A student with proven immunity to Hepatitis B will not have to worry about becoming infected through contact with infectious body fluids. 

And here’s a little-known fact:  Some people who receive all their immunizations do not become immune.  These people are known as “non-responders” and research has shown that additional booster shots are not likely to result in immunity.  Titers help us identify these people so that they are protected in certain situations.  For example, someone who is non-responsive to the measles vaccine may have to go on furlough if a measles outbreak hits KUMC.  Other people who do not become immune to Hepatitis B will need to receive a shot of immune globulin if they come in contact with blood or body fluids of a person who is infected with Hepatitis B. 

Titers serve another important function.  Some students cannot access their childhood immunization records.  If this is the case, we will accept a titer as proof of immunity and the vaccinations will not need to be repeated, as long as you are immune.

Titers may also be required in clinical settings outside KUMC.   At KUMC, we sign contracts with outside agencies so that our students can rotate there.  Some of these contracts specify that titers are on file.  KUMC is subject to audits to prove that we are keeping our contractual agreements. 

KUMC Student Health offers titers at a very reasonable price.  Titers are $15 each, plus a $15 venipuncture charge.  If you have not had your titers done before coming to KUMC, I highly recommend that you do them through our office.  It is generally less expensive, and you are guaranteed to get the correct blood test without additional unnecessary tests.  Of course, we will also accept titers from outside sources as well.  Call 913-588-1941 if you would like to schedule your titer or if you have additional questions. 
My name is Jennifer Blanck, RN, and I am always happy to hear from students and help in any way I can. Feel free to give me a call if you have any questions regarding your requirements. My direct line is 913-588-2018.