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Hospitals Face Legal Dilemma In Testing Incapacitated Patients

Tue, 08/31/2010 - 7:05am

Anaesthetists are calling for greater clarity on the legal implications of testing incapacitated patients for blood-borne viruses, after a survey found that this is often done following staff needlestick injuries, in possible breach of UK legislation. The paper, in the September issue of Anaesthesia, reports on the results of an anonymous survey of intensive care units in England, Wales and Northern Ireland.

They survey showed that 63 percent of the units who responded had recorded an incident where a member of staff had suffered a needlestick injury while caring for an incapacitated patient in the last 12 months,  says the paper's lead author Dr. Lorna Burrows.

Analysis of the results showed that:

  • In just over 90 percent of cases, staff did not know whether the incapacitated patient had a blood borne virus.
  • 61 percent of patients were told they had been tested when they regained consciousness.
  • Less than one-third of the healthcare workers took post-exposure medication following their injury and less than half took this action even when they knew the patient had a BBV.

“Needlestick injuries are very common in the UK National Health Service and account for 17 percent of accidents,” says Dr Burrows. “The annual incidence is estimated to be as high as 623 per 10,000 staff, but poor reporting could mean that it is even higher.”

Guidance issued by the Department of Health suggests that employers have a responsibility to assess and manage the risks associated with needlestick injuries and protocols are generally managed by occupation health departments. This includes screening for BBVs such as HIV and hepatitis.

“If the patient is conscious, they can be asked questions about their medical history and for permission for blood tests to be carried out. But if the patient is unconscious, they cannot give consent. If staff tests a patient's blood without their consent, and this test is solely for the benefit of the healthcare worker who has had the needlestick injury, then it could be argued that this is unlawful.”

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