Mandatory Patient HIV Testing after Needlestick Injury

MsPiggy · Jan 17, 2007

Actually we have this right in our consent to treat form the patient signs on admission. I'm for it, it's a good thing and provides us with a heads up if the patient is postive for HIV/Hepatitis, a lot of my patients are positive hepatitis/hiv so it's a good thing.

-Ms.P

HappyNurse2005, RN · Jan 17, 2007

its one of the consents they sign upon admission to the hospital, and is part of hte surgery consent form,too. and the patients are told this, too.

bethin · Jan 17, 2007

Actually we have this right in our consent to treat form the patient signs on admission. I'm for it, it's a good thing and provides us with a heads up if the patient is postive for HIV/Hepatitis, a lot of my patients are positive hepatitis/hiv so it's a good thing.
-Ms.P

The same goes here except that consent form is only signed when going to surgery. Had a 6 month pregnant nurse get stuck on the floor. Pt was in mid 20's and refused to be tested for HIV. Nurse had a hard time: risk getting HIV or risk her baby's life and take the cocktail. She ended up risking it and has tested neg since. And one had to wonder why an a/o woman in her 20's would refuse the test. That would throw up some flags for me.

I got stuck once but the pt was a surgery pt and they tested her blood that was leftover after surgery. She came back neg and I had to be tested for a year (I think). I was never offered the cocktail, which I think I should have. No one knows when the pt was infected - it could have been the day of or day before. Maybe she didn't have enough antibodies. Doesn't matter now.

ICRN2008, BSN, RN · Jan 17, 2007

Even though HIV testing after needlestick injury is part of the "consent to treat" form, patients have a right to withdraw this consent at any time.

To conduct a blood draw after a patient changes his or her mind would be considered assault.

MsLady06 · Jan 17, 2007

How do you get stuck with a HIV needle? or any needle?

bethin · Jan 17, 2007

How do you get stuck with a HIV needle? or any needle?

I'm not sure what you mean about HIV needles. But to answer the second sentence: I was cleaning a pump and surgery had left a needle dangling. Don't know why it was there. It was capped but taped to some tubing. I was ripping the tape off when the needle came uncapped and stuck me in the finger.

As far as getting stuck: pt's can move when you are giving an IM. It happens. To think that you will never get stuck in this line of work is naive. You may go 20 years and not get stuck then something happens and you do. I can imagine there were people who got stuck when they were getting a UA on a pt with a catheter. Now, we have the needle free ports.

Needle sticks still need to be reported even if you know the needle is clean. For ex, if you are drawing out of a vial and in the process stick yourself. You know that needle is clean but it still needs to be reported.

MsLady06 · Jan 24, 2007

I'm not sure what you mean about HIV needles. But to answer the second sentence: I was cleaning a pump and surgery had left a needle dangling. Don't know why it was there. It was capped but taped to some tubing. I was ripping the tape off when the needle came uncapped and stuck me in the finger.
As far as getting stuck: pt's can move when you are giving an IM. It happens. To think that you will never get stuck in this line of work is naive. You may go 20 years and not get stuck then something happens and you do. I can imagine there were people who got stuck when they were getting a UA on a pt with a catheter. Now, we have the needle free ports.
Needle sticks still need to be reported even if you know the needle is clean. For ex, if you are drawing out of a vial and in the process stick yourself. You know that needle is clean but it still needs to be reported.

OMG your going to have me paranoid! I've never been stuck but I will sure try and be as careful as possible. It was never quite clear to me how people get stuck with ANY needle while working. I thought they may have had a patient who purposely did it or maybe stepped on one.

tvccrn, ASN, RN · Jan 24, 2007

Mine happened as I was trying to get the air out of some dialysis tubing. I was in the PICU and the machine alarmed. According to the dialysis nurse, all I had to do was take a clean needle and pull the air out of one of the ports. To do this you have to hold the tubing with one hand pull the lever that held the tubing in palce with the other hand and insert the needle into the port withdrawing with your third hand. Yeah, right. The needle slipped and, viola, there it was sticking out of the side of my hand pull the lever open. The patient's parents conseted to testing and all were negative. Thank goddess.

tvccrn

Trauma Columnist · Jan 25, 2007

IL does NOT require consent for HIV/hep testing when it involves a needle stick. However, since we are talking about needle sticks: its not the HIV needle sticks you need to be concerned about. The transmission rate is extremely low. Hepatitis however is again on the upswing and it is much easier to transmit. "Exposures from needlesticks or cuts cause most infections. The average risk of HIV infection after a needlestick/cut exposure to HIV-infected blood is 0.3% (i.e., three-tenths of one percent, or about 1 in 300). Stated another way, 99.7% of needlestick/cut exposures do not lead to infection."

http://www.hivpositive.com/f-OccExposure/OSHA/faq.htm

And another article on transmission of hepatitis:

http://www.emedicine.com/emerg/topic244.htm

ronsrn · Sep 23, 2010

anyone know the law in Arizona we had a young 20's girl stuck by a psych pts blood , the Dr's would not sign a 2 Dr consent and they had deemed her incompetant and even though she would have let someone they did not allow the test. Can a CD4 be taken without consent by the Dr's especially if they could be ruling out the reason for ALOC? Shame on these facilities for not protecting their employees better. AND FOR those that answer they have to abide by the law , laws can be changed