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CENTERS FOR DISEASE CONTROL AND PREVENTION GUIDELINES
Generally accepted standards and recommendations have been developed by the Centers for Disease Control and Prevention (CDC) for the prevention of transmission of the human immunodeficiency virus (HIV), hepatitis B virus (HBV), and hepatitis C virus (HCV) in healthcare settings. These recommendations emphasize adherence to standard precautions that require that blood and other specified body fluids of all patients be handled as if they contain blood-borne pathogens.
The CDC guidelines and recommendations are based on the following considerations:
1. Infected nurses who adhere to standard precautions and who do not perform invasive procedures pose no risk for transmitting HIV, HBV, or HCV to patients.
2. Infected nurses who adhere to standard precautions and who perform certain exposure-prone procedures pose a small risk for transmitting HIV and HCV to patients.
3. HIV is transmitted less readily than HBV and HCV.
In accordance with CDC guidelines, the following standards are to be followed to minimize the risk of transmission of blood-borne infections, such as HIV, HBV, or HCV:
1. In the provision of nursing care, all nurses should: A. Adhere to standard precautions, including the appropriate use of hand washing, protective barriers and care in the use and disposal of needles and other sharp instruments; and
B. Refrain from all direct patient care and from handling patient-care equipment and devices used in performing invasive procedures if the nurse has exudative lesions or weeping dermatitis; and
C. Comply with current guidelines for disinfection and sterilization of reusable devices used in invasive procedures; and
D. Know his/her HIV antibody status and HCV status if performing exposure-prone procedures in the provision of care. Nurses who perform exposure-prone procedures and who do not have serologic evidence of immunity to HBV from vaccination or from previous infection should know their HbsAG status and, if that is positive, should know their HbeAG status.
2. Currently available data provide no basis for recommendations to restrict the practice of nurses infected with HIV, HBV, or HCV who perform invasive procedures not identified as exposure-prone, provided the infected nurse complies with standard precautions and current recommendations for sterilization/disinfection.
3. Nurses who are infected with HIV, HBV (and are HbeAG positive) or HCV should not perform exposure-prone procedures unless they have sought council from an expert review panel and have been advised under what circumstances, if any, they may continue to perform these procedures.
The Board of Nursing may request to convene an expert review panel. The Board may appoint a panel to include experts who represent a balanced prospective. Such experts might include all of the following: (a) the nurse’s personal physician(s); (b) an infectious disease specialist with expertise in the epidemiology of HIV, HBV, and HCV transmission; (c) a health professional with expertise in the procedures performed by the nurse; and (d) state and local public health offficial(s). If the nurse’s practice is institutionally based, the expert review panel might also include a member of the institution’s infection control committee, preferable a hospital epidemiologist.
4. CDC guidelines define exposure-prone procedures as follows:
“Characteristics of exposure-prone procedures include digital palpation of a needle tip in a body cavity or the simultaneous presence of the health care worker’s fingers and a needle or other sharp instrument or object in a poorly visualized or highly confined anatomic site. Performance of exposure-prone procedure represents a recognized risk of percutaneous injury to the health care worker, and - if such injury occurs - the health care worker’s blood is likely to contact the patient’s body cavity, subcutaneous tissues, and/or mucus membranes.”
Also read this:
http://www.ci.austin.tx.us/health/downloads/resmanual.pdf
