Blood Born Pathogen exposure and faucility refuses to test pt.

Altra, BSN, RN · Jul 21, 2006

Is it the facility that is refusing to ask the patient to be tested, or the patient who is refusing?

I'm not a legal expert on this, but I doubt that the facility can force the patient to undergo testing.

At my facility the protocol goes something like this: in the event of exposure, the patient is asked to allow blood sample collection for the purpose of testing. The patient can refuse, just as they have the right to refuse any other procedure.

Depending on the circumstances of the exposure incident, the staff member exposed might wait for results of testing (24-48 hrs) or immediately begin prophylactic treatment.

sbic56, BSN, RN · Jul 21, 2006

So long as you have had yourself tested, you can petition for a court order when the source person refuses to voluntarily have their blood tested. Your employer should be able to help you with this.

KellNY, RN · Jul 21, 2006

Smile--it's illegal for them to test the patient/resident without informed consent, no matter how bad you want it done.

sbic56, BSN, RN · Jul 21, 2006

Smile--it's illegal for them to test the patient/resident without informed consent, no matter how bad you want it done.

Not entirely true. A court order can be obtained if the source patient refuses. I imagine this may very state by state, as I am not absolutely sure if it is federal law, but I know in Maine, if a court order is obtained, the source person's blood sample can be obtained without their consent. I did a quick search and this is true in a few other states that I know of...Florida for one.

Altra, BSN, RN · Jul 21, 2006

Not entirely true. A court order can be obtained if the source patient refuses. I imagine this may very state by state, as I am not absolutely sure if it is federal law, but I know in Maine, if a court order is obtained, the source person's blood sample can be obtained without their consent. I did a quick search and this is true in a few other states...Florida for one.

There is probably some version of this in most, if not all states ... but practically speaking, if there was enough significant concern to warrant obtaining a court order, you'd want to start prophylactic treatment in the meantime. Unless there is specific legislation stating otherwise, the individual staff member exposed in the incident might have to bear the legal fees incurred in obtaining a court order if the facility was unwilling to do so. Not that that would stop me, if I felt it was necessary ...

sbic56, BSN, RN · Jul 22, 2006

There is probably some version of this in most, if not all states ... but practically speaking, if there was enough significant concern to warrant obtaining a court order, you'd want to start prophylactic treatment in the meantime. Unless there is specific legislation stating otherwise, the individual staff member exposed in the incident might have to bear the legal fees incurred in obtaining a court order if the facility was unwilling to do so. Not that that would stop me, if I felt it was necessary ...

If there is a law in place, it is up to the employer to pick up the tab of costs incurred. The point of having the other person tested is to avoid starting on harsh meds prophylactically. Of course, like the poster pointed out, it may be that the source patient hasn't tested postive yet, so prophylaxis would have to be a decision weighed against risk. Nothing simple about a situation like this. I am the infection control nurse at our agency, so I had to get all this down so I could inform new employees at orientation. It is complicated for sure.