Help with Hospital Policy

[MuleMarine]

Hey all, my first post, been a closet reader for a while now. I need some direction and advice. I've been an RN for about 8 mo now, today I was OG suctioning an ETOH pt when he coughed some blood tinged, mucousy flem into my eye (not intentionally). I quickly removed suction and washed my eye for about 2 min. Then reported to my Assistant Nurse Manager (ANM) on what to do next. I was sent down to employee health where they started a chart and drew some blood on me. The pt's last Hep C panel was in Jul, all "negative". The problem is acquiring the HIV test. The pt's condition has worsened from this AM. He is not alert nor orientated, unable to follow direction, basically he's "Pickled" from ETOH. He is high risk for HIV, Hep C, etc. At this point we are unable to gain consent from this fella. I've chased this thing all the way up to our Chief of Medicine, at which point it's appeared to stall, at least for now. The 2hr prophylaxis is pretty much out the window at this point, since it's been over 8hrs! I'm wondering what avenue of attack I should approach if this continues to be a stalemate? Are there laws that can protect me?

[lands1980]

I would go to Employee Health ASAP and fill out a First Incident of Injury. My brain is failing me but there is a offical form for Worker's Comp. Keep journal of all contacts with who what and why with EH and all paperwork. You need baseline lab work for Hep B,C and HIV and serial lab work for recheck. OSHA website has info. Get the Policy and Procedure and Employee Handbook get informed about workplace injury at your hospital.

Where was the charge nurse and house supervisor with this event?

[MU/WVUGRADRN]

What is your facility's policy about needle sticks?

I believe at our hospital, if there is a needle stick, the patient does not have to give consent for HIV testing. No charge to pt since is done for employee protection.

I think you could try to equate this fluid exposure to a needle stick to get the testing done? Just an idea.

Try running this past employee health.