Patients should ALL be swabbed tested for HIV

1 needle stick postings break my heart!
why aren't all patients given the swab test for hiv upon entrance to a hospital so nurses can take extra precautions?
i realize that the test is not difinitive but it would alert nurses for those that test positive.
i also realize that nurses take precautions with every patient but surely they would be more aware and more cautious with an hiv patient.
patients in labor are tested prior to birth, why not everyone?
Because we stopped alienating, segregating, and isolating HIV+/AIDS patients a long time ago. We have standard precautions for a reason, to protect ourselves, and to protect the privacy of our patients. I have had new grads flat out refuse to walk into an HIV+ patient room because of old school fears. Some of those patients have been my best, most compliant patients. I assume everyone has HIV/Hep C and protect myself accordingly. My fear can be contained in procedure and does not require me to label them for it to work. Babies are a different case because they need to be aware of all possible infections and suppression on their systems. I don't have more research on this at the moment, but am sure some of the following posters could provide more succinct evidence to this.

The most recent needle stick post I've seen mentions that the patient was confirmed to be HIV and hep C + before the stick....and it sounds like the nurse was very cautious- it was just a weird, freak thing

I don't think that would make a significant difference, other than ostracize patients even further. Here's two things I assume of every patient:they may have a blood borne disease (Hep C, etc)they are unpredictable and may attack me at any time (I worked in a prison, but I've had little old ladys in various units do the same thing). I think it's a good belief for anyone.I also think that regardless of how good our precautions are, it is a risk we take as nurses. I hope the best for all needle sticks.

What "extra precautions" should a nurse take when treating an HIV + patient?

To answer the OP, cost effectiveness. With standard precautions, transmission of HIV is pretty much impossible unless there's an accident. Hard to see that there's still such fear when the epidemiology has been well-known for 40+ years.

Universal Precautions work with all patients. Another tip, if you think you need to use PCP, then you probably do. I am so flipping tired of hearing from exposed employees "I always am extremely careful when caring for an HIV patient". Yet they present with an eyesplash from bloody sputum while suctioning-never protected their eyes/mouth. Or, "I am always so careful with Hep C patients" and there they sit with a hollow bore needle stick injury after RECAPPING a dirty needle, OR failing to activate the safety mechanism...or, starting an IV and leaving the needle in the linen. Just my 2 cents.

Will u take a pay cut so each and every patient gets HIV swabbed - the collecting, the recording, the test itself?How about Hep C? Standard Precautions protect the nurse, each and every needlestick has one loophole - "Ohh It just moved all of a sudden" or the bed wasnt high enough and RN had to maneuver etc etc..

In some states, testing all pts for HIV without their consent would be an invasion of privacy. I know when I worked in PA you could not do an HIV test on a pt without their consent, even in a needlestick situation. While some states will let you test without consent, it's too much of a legal nightmare to routinely test pts for no reason.

Quote from cathyladyneedle stick postings break my heart!why aren't all patients given the swab test for hiv upon entrance to a hospital so nurses can take extra precautions? i realize that the test is not difinitive but it would alert nurses for those that test positive.i also realize that nurses take precautions with every patient but surely they would be more aware and more cautious with an hiv patient.patients in labor are tested prior to birth, why not everyone?

Quote from ChristineNIn some states, testing all pts for HIV without their consent would be an invasion of privacy. I know when I worked in PA you could not do an HIV test on a pt without their consent, even in a needlestick situation. While some states will let you test without consent, it's too much of a legal nightmare to routinely test pts for no reason.

As we've seen, the stigma persists. HIPAA notwithstanding, test results get out and can create endless problems for pt, family, friends and facility. I've seen it happen.My involvement with HIV/AIDS goes back to the 80's before testing was available at all, so I'm perhaps a little oversensitive to the stigmatization and avoidance that still occurs.The only rationalization for blanket testing that I can think of is to uncover previously unknown infections ... but you'd have to also provide the counseling and education for new positives, as well. Runs to a lot of time, money and aggravation for all concerned for very little to no return.

It has to do with privacy and that is why you need someone's consent to test for HIV. Also if you are using standard precautions than what extra protection do you need?