I am doing a sort of research project for school regarding HIV. We are trying to research the policy regarding reporting of HIV positive patients to healthcare providers. I live in NC and have read over the laws regarding HIV reporting, and it looks like just the primary physician has to report the positive test and name to the health department.
The questions that I have are: Is it standard procedure to screen for VRE and MRSA in patients admitted to hospitals, or is simply for high risk patients, or patients that exhibit s/s of an infection? Also, is informed consent needed for screening of VRE and MRSA? Finally, is it up to the patient to inform nurses that they are HIV positive or can consent be obtained to have this information released and put in a medical record?
The reason that I am asking all of this, is that it seems like so much confidentiality is placed around HIV testing and results, but if someone has VRE or MRSA isolation precautions are taken (signs put on doors, etc.) and it is broadcasted that these patients are infected with either VRE or MRSA. I know the transmission rates are much higher with VRE and MRSA and healthcare providers can become infected simply by contact, but we're trying to figure out what the difference is with HIV (simply the stigma of the disease?).
Although we've all learned that simply using standard precautions can prevent HIV infection many nurses don't follow these precautions. Apart from the stigma of HIV, I don't really see what the difference is in having it in a medical record like VRE, MRSA, or something like Hepatitis.
Thanks in advance!
Apr 2, '08
about the confidentiality aspect of your post:
VRE/MRSA are generally acute and non-lethal (though not always), while HIV is a chronic lethal condition that historically faces stigma & opens patients to discrimination in many aspects of their lives (ex. employment, residence, memberships, etc...). Remember when HIV used to be thought of as a "gay disease"? As if people w/ lifestyles different than mainstream deserved the disease somehow? These types of discussions were going on in the 80's and 90's!
Also, on a healthcare unit, standard precautions protect all of us from HIV. VRE/MRSA require extra precautions in order to protect staff and the other patients on the floor (ie. these infect via nosocomial transmission, whereas HIV should not). VRE/MRSA can spread on a hospital floor from patient to patient, but this is not the case with HIV.
Last edit by grad*student on Apr 2, '08