Isolation for AIDS patients who are bleeding

nurseygrrl, LPN · Dec 2, 2003

I work in a Skilled Nursing Facility that has an HIV unit. I was floated up there for the first time about a year and a half ago. The DON asked me if I had a problem with it and I said no...but when I had to do a finger stick and then cover with insulin, I freaked out for a second.

After that initial jitteriness everything was fine for me. I ended up being a permanent floater to that floor and I know all the patients well. They are free to roam the whole facility as they wish, whether they are bleeding from somewhere or not and they are treated like anyone else. These pts. are all mentally ok and know to come to us if they get a cut etc. and then we address it. I feel very fortunate to work with this population because it has opened my eyes a lot about this disease.

The point is Tweety, when someone first encounters a pt. they KNOW is positive, they might overreact, but maybe you and even the pt. themself (depending on the situation) can put them at ease. Good luck!!

Rapheal · Dec 2, 2003

Originally posted by HerEyes73
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They are free to roam the whole facility as they wish, whether they are bleeding from somewhere or not and they are treated like anyone else.

Please do not flame me for saying this- but please tell me that you are not letting bleeding patients roam the facility. Does not matter their HIV status- a bleeding patient should not be roaming and spreading blood in a healthcare facility. And any bleeding patient should be under close supervision. Do you mean that they have a wound that is draining slightly?

And Tweety- I definately would not put a patient with a "weeping" wound in isolation unless MRSA or VRE but I would have them in a private room and would make sure that they had a dry and intact dressing before they left the room. Same precautions I take for patients who have cellulitis.

I have cared for AIDS patients in the past- no worries. But I will follow universal precautions. And sometimes this means telling the patient they can not ambulate through the halls when they have weeping cellulitis that is soaking through their dressings. I have had patients like this who think they can go and wander because they are in a wheelchair. This is not fair to our other patients.

The reason I am responding to this post in this way is that I work with many lax nurses who allow patients to ambulate while they have open wounds and weeping wounds. We need not to discriminate against any of our patients- but we need not be apathetic to the risks of infection to our other patients as well.

nurseygrrl, LPN · Dec 2, 2003

Please do not flame me for saying this- but please tell me that you are not letting bleeding patients roam the facility. Does not matter their HIV status- a bleeding patient should not be roaming and spreading blood in a healthcare facility.

No, that's not what I'm letting my pts do!!! :roll

Everyone's wounds are properly dressed and bodily fluids contained while they are roaming Also, wounds on these pts are few and far between.

Tweety, BSN, RN · Dec 2, 2003

Rapheal, I appreciate your input. Her platelettes are low. She has terrible itching and scratched herself on her arms and there are some skin tears that won't stop bleeding. They slightly oooze continuously, one on her arm and a couple on her face. No biggie IMO. Unless the person in the next bed crawls into bed with her, that other patient isn't at risk.

Our policy is to isolate cellulitis patients as well, until we get cultures back.

Rapheal · Dec 3, 2003

Originally posted by HerEyes73
Everyone's wounds are properly dressed and bodily fluids contained while they are roaming Also, wounds on these pts are few and far between.

Good job. I wish our facility was as diligent. And Tweety- I agree. A little excoriation is nothing I would worry about too much either. I thought perhaps her scratches were weeping from infection. Have a nice day.