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I don’t think it’s illegal because as a health care provider we can’t pick or choose who we take care of.

We are taught universal precautions in infection control and to treat everyone as if they are positive for such blood borne/body fluid precautions.

What would you have done differently? If you are using your PPE ( personal protective equipment) you should be as safe as you can be under the circumstances.

A C.diff person should not have a roommate for obvious reasons.

But while its nice if you know everyone’s diagnosis but sometimes you just don’t know! Thus proceed using your PPE for everyone you care for.

I don’t think it’s illegal. Think about the cleaning staff in a long term care center or hospital. They don’t know everyone’s status as far as infectious disease but using their PPE if used correctly is meant to protect themselves against any pathogen.

Believe me, as a RN while I think it’s absolutely necessary we are told upfront about any communicable illness sometime it doesn’t happen so protect yourself with the tools you have.

I am almost certain that staff must have inservices about infection control twice a year. That was common practice under Federal law consistent with nursing home regulations who adopted those CDC guidelines. Thus infection control mandatory inservices must occur. We had to sign an acknowledgment for our personnel file.

Those requirements do not vary state to state. State Staff infection control education requirements incorporateS the most recent CDC recommendations into their center guidelines. Blood borne pathogens/Infection control are to be completed twice a year and documented in the employee file. This info can be found in the Federal register of conditions of coverage guidelines for Medicaid nursing homes. The states incorporate the federal guidelines on infection control into their laws.

Nursing homes have their own care standards dictated by the Federal register (as do dialysis centers).

Last time I worked with a chronically ill clientele was in a dialysis center. In that setting we often had patients who were known HgAG positive (hepatitis B). Those patients were supposed to dialyze in isolation. But interestingly enough, a HIV positive patient was not mandated to have to dialyze in the isolation area. That sort of shook the staff up a little back in the beginning of when we began to see more HIV positive patients.

Illegal? I think not. If you feel you need better inservices on infection control, ask your supervisor for a refresher Infection control inservices.

Good luck to you!
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rovana Apr 2019
Are the regular infection control procedures enough to protect caregivers in real-world facility situations? Remember in TX a couple of years ago, the Ebola patient. I'm sure they used those procedures but as I recall they were not sufficient.  With the rush to take care of too many patients, I'm sure corners get cut.  I believe full disclosure is morally more important than protecting a patient from embarrassment (the HIV confidentiality thing). Some patients are more dangerous to caregivers than others and so there is a reasonable need for staff to know, IMO.
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There should be supplies outside the room and you should be instructed to mask, gown, glove before entering the room.
Not sure if informing workers of an infection would be a violation of HIPPA or not.
I do not know if it is illegal if they do not inform you but in theory you should treat everyone like they have the potential to infect you.
Great if you know if someone has been diagnosed with an infectious disease but what about someone who has not yet shown symptoms or is a carrier and will never show symptoms?
So glove use is always safe, hand washing before and after gloves would probably be ideal.
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I'm not in the USA either but I can't imagine there isn't a protocol that has to be followed both to protect staff and to prevent the spread to others within the facility. Where I live there would be a very visible sign at the entrance to the room as well as whatever level of safety equipment is required - gloves, masks, gowns, face shield if needed. The SARS outbreak was a long time ago but the lesson has not been forgotten.
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Could you please give us more information?  Do you mean your loved one or another resident in the facility?
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Stephanie44 Apr 2019
A senior living facility resident. Two days ago my supervisor said its ecoli not cdiff so ill be om with just glove on and no gown . She aslo said just dont let the poop touch you
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I would think that it would have been nice if they told you but against the law? Not sure. I would think the Health Department would have been informed and they would have come in and set up procedures. Some kind of procedure should have been implemented like Grandma said.

Call the health department and ask if procedures should have been implemented and staff informed.
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worriedinCali Apr 2019
could vary from state to state but in California the health department isn’t involved in AL or LTC, they don’t set up procedures in facilities. It’s the state that determines the proper protocol. The health department is notified but they don’t come in and do anything.
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Yes it is wrong and probably illegal because when it comes to INFECTIOUS DISEASES there are certain protocols that must be followed BY LAW. The law will vary from state to state. And seeing as how you work in an assisted living facility, they may be in violation of state regulations by allowing someone with c-diff to remain on the premises.
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Shell38314 Apr 2019
Blood borne pathogens/Infections guidelines are not set by state to state. These guidelines are set by Federal law and the CDC as Shane stated.

If one chooses to work in the Healthcare field then one chooses what it all comes with it. There is no way to know everybody's dx. You must assume that everyone is infected this is why you wear PPE.
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A resident? Do you mean a resident you are working with directly, or just a resident in the facility where you work? What job do you do?
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Stephanie44 Apr 2019
A resident. I don't know what to believe because now they're saying she only have ecoli. Do I still need to protect myself
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I am not in the USA.

I was with a friend in ER last fall. One of the other ER patients was suspected of having an infectious disease. There was a sign hung at the entrance to her cubicle telling all staff to fully mask and gown before entering. I could see the procedure all staff went through each time they entered and it was far more than the usual washing of hands and gloving up.

When my grandmother was in isolation 30 years ago there was a sign on her door that everyone had to fully mask and gown.
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worriedinCali Apr 2019
I’m in the US and they do the same thing at the hospitals here in California. They don’t treat all patients the same, if you are contagious or have an infectious disease, they take extra precautions—gown type thing, shoe covers, face mask, gloves.
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I think if you were using proper personal protective equipment this would be a mute point.

Are you worried about being responsible for spreading something from one resident to another because proper procedures were disregarded?
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Stephanie44 Apr 2019
Yes I am but now the supervisor is saying she has ecoli. Should I continue to protect myself?
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One way around this, have a big sign on or near the door of the room with CONTAGIOUS in big bold letters.
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Shane1124 Apr 2019
No that would be a huge violation of patient privacy laws. They are called “Universal precautions” for a reason. A healthcare worker approaches the person they are assigned to gowned, gloves & masked. Additional focus can be for respiratory precautions or wound precautions. Any healthcare worker should hit the floor running after training in Universal precautions. The employee is required to sign and acknowledge this training and is kept in their employee file.
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