Bloodborne Infections 'need to know' for providing care?

[ZASHAGALKA, RN]

I thought this deserves its own thread.

In another thread, about RNs refusing to start IVs, the discussion came up that, due to Standard Precautions, there is no inherent need for healthcare providers to be informed of the bloodborne infection positive status of pts under their care.

The example was a nurse that didn't like to start IVs on pts that had HIV or Hepatitis. So, she asked others to start those particular IVs, even though she was 'expert' at IV starts, in general.

But, so that others would DO this for her, she neglected to tell them of the positive HIV/Hepatitis status.

What is your opinion on this? Do you need to know this status to provide care? Or, is Standard Precautions sufficient?

~faith,

Timothy.

[ZASHAGALKA, RN]

my take:

You should always be a cautious driver. But, when the gov't knows a particular stretch of road is hazardous, they go OUT OF THEIR way to post additional caution signs.

None of us need lecture about standard precautions.

But, it is still highly dangerous and rude to not inform a co-worker of relevant issues relating to nursing care: and knowing that a pt has a bloodborne dx is absolutely relevant to a request to work w/ that pt's blood.

I would consider that if a nurse asked me to start an IV and purposely failed to reveal their HIV status to me: that is an act of treachery.

Platitudes are one thing. Standard precautions yada yada. But EVERYONE knows that actual hazards, as opposed to potential ones, receive more caution. That is simply human nature.

~faith,

Timothy.

[Tweety, BSN, RN]

Good question.

Universal precautions is all one needs to start an IV. So technically the answer is no.

It seems a bit unethical to me to refuse to start IVs on infected people and then not tell the other person.

If I miss an infected person and ask someone to start an IV, I tell them. Too many nurses don't always use standard precautions. Some older nurses who learned to start IVs without gloves don't always use gloves.

[grinnurse, RN]

IMO although universal precautions s/b sufficient, I have seen countless nurses, both older and newer start IVs with out gloves, especially on the "hard" to stick pts, ie. drug abusers, etc. so to me that is unethical on the part of another person not to inform the one starting the IV.

If I were working with that nurse and found out she put me at that risk, that would be the last IV I started for her.

[twinmommy+2, ADN, BSN, MSN]

Thats pretty crappy of a coworker to do that to others. Kinda says how she feels about them doesn't it?

But to answer your question, no, I don't need to know the status of a patient to do my job. All patients under my care get the same treatment no matter what disease they have

[elkpark]

Thats pretty crappy of a coworker to do that to others. Kinda says how she feels about them doesn't it?

But to answer your question, no, I don't need to know the status of a patient to do my job. All patients under my care get the same treatment no matter what disease they have

Ditto ...

[elthia]

I have taken care of too many people who were later found to be HIV + or Hep C+, days/weeks/months after I've been caring for them. I dont' think it matters unless they have draining wounds, and that's only for cohort purposes. But as a "newer" nurse, I was trained from the getgo to always wear gloves and to abide by the rule "if it's wet and not yours DON'T TOUCH IT". If I were to recieve a needlestick, I'd worry even if the pt was not a known HIV carrier, because s/he might just be HIV+ and has never been tested for it.

I guess it really depends, I remember a pt on a different floor who was HIV+ and would unhook his IV tubing and purposefully sling blood all over the room...so staff had to go in gowned, gloved, and wearing masks with eye shield...but that's a really extreme case.

[Blee O'Myacin, BSN, RN]

I don't start many peripheral IVs since we usually get our admits with an existing central line, but when I do start one, I just assume that there is something bloodborne and take appropriate precautions. An ounce of prevention is worth a pound of cure - or so the saying goes!! :trout:

I can understand the discomfort of a nurse not wanting to insert an IV or otherwise stick an HIV positive or Hep C positive patient, but to expect her/his coworkers to do it for them is just plain wrong!

Blee

[Katnip, RN]

I don't need to know the patient's status to start IVs, etc. If I were exposed, then I would definitely want to know.

However, knowing a patient's HIV or Hep status may be important in other aspects of treatment, such as medications and such.