Tagging HIV status in chart?

Specialties MICU

Published

Hi Everybody,

I was wondering what your hospitals' protocols are for tagging HIV status in the chart or communicating HIV status to nurses at shift change. I know that we should always be using universal precautions, but I think that nurses should have a heads up if their patient is HIV positive so that we can be extra careful. At my hospital, we have bright stickers in the chart for allergies and also for MRSA and such. Some charts on my unit on the front "diagnostic list" sheet will list CD4 count or "very immunocompromised" or some other "code" indicator of possible HIV positivity. If there's a definitive notice of HIV status in the chart, it's defintely not easy to find. This is the same for other infectious diseases.

Are there some hospitals where HIV status is more prominately tagged? Do you think that HIV and other infectious diseases should be more prominantly tagged as a safety measure for nurses?

Thanks!

Specializes in Telemetry, ICU, Resource Pool, Dialysis.
My problem with it is too many nurses are ignorant about HIV. They are judgemental and have no idea how it is actually spread. I hate to say that, but I've seen it over and over again. If you are following basic protocols, you'll be fine. If you aren't, you're taking a risk with every patient you come into contact with (because a HUGE percentage of people with HIV and Hep C don't even know they are infected) and this will only provide you with a false sense of security. You already have the knowledge to protect yourself without some special flag in the chart. If you or your coworkers don't use it.... well that's another issue.

As far as starting IVs without gloves.... I know I'm going to get flamed for this, but unless you have some open wound on your hand, simply touching HIV tainted blood isn't going to infect you. If you think you have any possible open wounds on your hand you should be wearing gloves to protect the patient from you.

You are so correct, fergus. Unfortunately, the stigma of HIV comes with it - even for us in the healthcare world - who should know better. I think someone said here that they thought people with known HIV got treated differently - I think you may be right. Whether we mean to or not - there are going to be the people who don gloves in front of the patient to refill a water pitcher, take a temp, remove a supper tray.

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You are so correct, fergus. Unfortunately, the stigma of HIV comes with it - even for us in the healthcare world - who should know better. I think someone said here that they thought people with known HIV got treated differently - I think you may be right. Whether we mean to or not - there are going to be the people who don gloves in front of the patient to refill a water pitcher, take a temp, remove a supper tray.

Exactly. HIV patients don't need any special precautions unless they are very sick and then it's to protect them, not the healthcare worker. I have seen some of the most ignorant and bigotted responses from nurses when dealing with HIV. I'm embarassed that as a group we sometimes aren't any more educated about HIV than the general population.... Until that changes I don't feel nurses need to know a patient's HIV status unless it's impacting their treatment in some way.

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Fergus51

I thought that last statement was interesting and also a good reminder for me. I saw someone accidentally get blood on their hand from a TB patient the other day and my first reaction was "yikes!" It didn't really seem to phase him, but if it had been me, I would have freaked out (inside) ...so thanks for reminding me that we need an open wound to get infected. (of course, he washed his hands right away)

Cali

"As far as starting IVs without gloves.... I know I'm going to get flamed for this, but unless you have some open wound on your hand, simply touching HIV tainted blood isn't going to infect you. If you think you have any possible open wounds on your hand you should be wearing gloves to protect the patient from you."

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LOL! I'd probably still freak a bit too Cali, but also wash right away. I don't know about you, but I'm in my late 20s and can't remember a world before HIV. Because of that we've all been completely sensitized to blood as being a disease carrier. Nothing wrong with that, but I do see how it can sometimes get a little out of control. We were talking about it at work the other night and I realized I would be a little freaked out to have sex without a condom even if I was married! Mingling of body fluids is just something I've been brainwashed to always think of as dangerous... OK, too much info right?:D

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Specializes in geri, med/surg, neuro critical care.

as far as starting ivs without gloves.... i know i'm going to get flamed for this, but unless you have some open wound on your hand, simply touching hiv tainted blood isn't going to infect you. if you think you have any possible open wounds on your hand you should be wearing gloves to protect the patient from you.

it's true that touching any bodily fluid with skin intact won't infect you...but how many of us really know if our skin is completely intact? remember the story of barb fassbinder? she was a nurse that worked in my area (rural wisconsin) in the mid 80's and contracted hiv from an er patient...she held gauze over an area, and when she lifted her hand, the blood had gotten on her fingers...she thought her skin was intact, no big deal, until a few months later when she tested positive...turns out, she had been gardening the day prior to the accident and she had tiny scratches on her fingers :uhoh21:

please, please, please be careful everyone...it breaks my heart when i hear nurses (or anyone else) becoming infected.

p.s.--fergus51--i hope you don't feel like i "flamed" you, but if it's allright, i'd like a little heat to make some hot cocoa :chuckle

~lori

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