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Bloodborne and Airborne Diseases

Position Statements

Documents

• Position Statement: The Health Care Service System and Linkage of Primary Care, Substance Abuse, Mental Health, and HIV/AIDS Related Services - 12/93
  Summary: Alcohol, tobacco and other drug (ATOD) abuse is recognized as one of the nation's major health problems. Clients with potential or unrecognized ATOD abuse problems frequently come in contact with health care providers for a variety of other health care needs. Professional nurses are in contact with clients in diverse settings at all phases of the health illness continuum and are therefore in a strategic position to link primary health care, substance abuse,HIV/AIDS and mental health care systems through recognition of needs, interventions and referral. The American Nurses Association is committed to universal health care coverage and delivery system reform which links primary care and ATOD abuse prevention and treatment systems.
• Position Statement: AIDS/HIV Disease and Socio-Culturally Diverse Populations - 4/02/93
  Summary: Culture embodies the values, attitudes, beliefs and practices of a group as well as its roles and structures, communication styles, technology, art, and artifacts. The numbers of reported cases of AIDS/HIV disease are dramatically increasing in some ethnic and minority groups. The American Nurses Association (ANA) supports the provision of skilled, knowledgeable and compassionate nursing care which respects client conscience and integrity, cultural values, beliefs, relationships and the right to make choices. Comprehensive educational programs that are culturally sensitive must be targeted to diverse population groups to assure that the transmission of the AIDS/HIV epidemic is stopped in all communities. Research which increases knowledge about socio cultural diversity is needed. Continued political action and advocacy is also needed to ensure quality health care for all, regardless of age, color, creed, disability, gender, health status, lifestyle, nationality, race, religion, or sexual orientation.
• Position Statement: Tuberculosis and HIV - 4/02/93
  Summary: Resurgence of Tuberculosis (TB) and the identification of Multi-drug Resistant Strains of Tuberculosis (MDR-TB) has created a major health threat in the United States. All population groups are potentially at risk, especially those individuals who are immunosuppressed, medically under-served, of low income status, in communities of color, migrant workers, injection drug users, immigrants or residents of long-term or correctional facilities. Nurses believe access is needed to essential TB testing, treatment, education, counseling, and follow-up services for the public and health care providers.
• Position Statement: Needle Exchange and HIV - 4/02/93
  Summary: An increasing percentage of HIV/AIDS cases are related to injection drug use (IDU). The sharing of contaminated needles is the primary method of transmission for intravenous drug users. Nurses support the availability of needle exchange programs which include adherence to public health and infection control guidelines, access for referral to treatment and rehabilitation services, and education about the transmission of HIV disease.
• Position Statement: Tuberculosis and Public Health Nursing - 4/02/93
  Summary: The American Nurses Association recognizes the importance of maintaining the role of the professional nurse in the pubic health system, responsible for primary, secondary, and tertiary care of the patient with tuberculosis (TB). The resurgence of tuberculosis (TB), including large nosocomial outbreaks of both drug sensitive and Multidrug-Resistant TB (MDR-TB) in several hospitals, correctional systems and community settings, has occurred partly as the result of the erosion of the public health infrastructure and a lack of discharge planning to the community health care system. The public health nurse must be preserved as an integral part of this infrastructure, responsible for patient management to ensure continuity of care after discharge; completion of an effective course of antituberculous therapy; and case finding and identification of newly infected persons through investigation of contacts and other surveillance activities, thus interrupting the cycle of disease transmission.
• Position Statement: HIV Exposure from Rape/Sexual Assault - 4/02/93
  Summary: Rape/sexual assault is a violent crime that impacts adults, children, men and women. Since 1980, according to the Federal Bureau of Investigation, (FBI), rape has increased more than any other violent crime. Only 10 percent of rape/sexual assaults are reported, making this the most underreported crime in the U.S. (Congressional Caucus on Women's Issue, 1990; Harlow, 1991; Koss, 1990). A person who survives a rape is placed at risk for both psychological and physical trauma. The rape survivor is also placed at risk for contracting HIV infection from an infected rapist. Nurses believe that access to survivor focused services which include appropriate HIV testing and prophylactic treatment should be available in health care settings.
• Position Statement: HIV Infected Nurse, Ethical Obligations and Disclosure - 12/11/92
  Summary: The HIV infected nurse is bound by the same precepts for practice as found in the Code for Nurses. The first duty is to protect the patient. Nurses who know that they have transmissible blood-borne infection should voluntarily avoid exposure-prone invasive procedures that have been epidemiologically linked to HIV or other blood-borne infection transmission. The nurse has a duty to provide warning to the patient who has experienced an exposure to sero-positive blood. Support and protection of the nurse with a positive sero-status as well as those who convert following exposure by an occupational incident has been a long standing position of the association. ANA supports the application of confidentiality to all information about the HIV infected nurse or nursing personnel.
• Position Statement: HIV Disease and Correctional Inmates - 9/11/02
  Summary: Federal, state juvenile and local correctional facilities house significant numbers of individuals who are at risk for HIV disease. Voluntary testing, strict application of Universal Precautions and CDC guidelines, education/counseling services, protective devices availability and confidentiality are important areas for nurses working in these settings. It is recommended that the HIV positive correctional health care worker has the same rights and responsibilities as in other health care settings. Other diseases, such as hepatitis B, and Tuberculosis also require attention by correctional facilities staff.
• Position Statement: HIV Disease and Women - 9/11/92
  Summary: Heterosexual transmission of AIDS/HIV is increasingly being identified as the primary mode of transmission and significant numbers of women now have the disease. AIDS is the leading cause of death for African-American women in some states. Most scientific knowledge about HIV infection disease is currently based on research on men. Models of care need to be developed for women which are culturally sensitive and relevant to the needs of women.
• Position Statement: HIV Infection and Nursing Students - 4/03/92
  Summary: The American Nurses Association (ANA) supports comprehensive education regarding AIDS/HIV infection for all nursing students. Nursing curriculum should include AIDS/HIV infection content including patient treatment, transmission, mechanisms for protection while delivering care to persons with AIDS/HIV infection and Hepatitis B (HBV) infection, instruction in universal precautions and occupational health and safety issues. ANA believes that the HBV vaccine should be a required component of each nursing student's pre-clinical evaluation and that schools of nursing should demonstrate 1) the availability of a post-exposure program for students who sustain exposures to AIDS/HIV and HBV infection in the clinical setting and 2) the mechanism for students to have access to health care services while enrolled. Schools of nursing should develop a mechanism for disability coverage for students who contract HIV or HBV infection through exposure in the clinical setting. Finally, nursing students should be assured clinical setting protections consistent with those of employees covered under the Occupational Health and Safety Act.
• Position Statement: HIV Infection and U.S. Teenagers - 12/13/91
  Summary: The American Nurses Association (ANA) believes the most effective strategy in dealing with the AIDS epidemic is prevention. Increased education about the risks of HIV infection should be a priority within community health nursing practice. ANA also supports the inclusion of information related to HIV transmission in school curricula.
• Position Statement: Education and Barrier Use for Sexually Transmitted Diseases and HIV Infection - 9/06/91
  ANA is aware that the focus of condom use in the past has been related to controlling HIV infection, however the rising numbers of reported sexually transmitted diseases indicate the education about condom use must be expanded and enhanced. The association believes that more aggressive and vigilant preventive community health measures are needed in the form of funding and preventive health programs dealing with information to control transmission and information about risks associated with the diseases. Education and information about methods that can be taken to avoid the risks associated with HIV infection, syphilis, gonorrhea, herpes virus and other sexually transmitted diseases are tools available to fight the spread of these diseases. Preventive health techniques, including safer sex practices, condoms, and other barriers reduce the possibility of transmitting debilitating, and in some cases, fatal diseases. In an effort to prevent and control the spread of HIV infection and other sexually transmitted diseases, ANA supports condom advertising in the mass media in support of the former U.S. Surgeon General's statement on the prevention of AIDS. ANA continues to work with the U.S. Public Health Service and other groups to educate the public on preventive measures.
• Position Statement: Equipment/Safety Procedures to Prevent Transmission of Bloodborne Diseases - 9/06/91
  Summary: The American Nurses Association (ANA) urges immediate and ongoing research and evaluation of devices and equipment intended to reduce risk of injury from sharps and of personal protective equipment designed to reduce exposure. In order to reduce the risk of exposure to bloodborne pathogens, ANA supports the consistent and strict use of universal precautions; the availability of proven safety measures; the standardization of methods to assure equipment is safe; and the continued evaluation and modification of work practices to assure optimum safety in the workplace.
• Position Statement: Personnel Policies and HIV in the Workplace - 9/06/91
  Summary: The American Nurses Association (ANA) has a long-standing position of advocating for the rights of nurses in the workplace. ANA supports development of personnel policies which create a maximally safe and healthful environment for all workers, patients/ clients, students, and volunteers. Personnel polices should address all aspects of HIV in the workplace; protect against social and economic discrimination; reflect the most current scientific and epidemiological knowledge; and incorporate sound principles of supervision and management.
• Position Statement: Post-Exposure Programs in the Event of Occupational Exposure to HIV/HBV - 9/06/91
  Summary: The American Nurses Association (ANA) encourages the prompt access to confidential post-exposure evaluations, counseling, and follow-up by knowledgeable clinicians. These procedures should be considered the standard of care by any health care agency. A comprehensive post-exposure program should be in place to assure that employees receive accurate information, guidance, reassurance, and supportive care.
• Position Statement: HIV Testing - 9/06/91
  Summary: The American Nurses Association (ANA) opposes perpetuation of the myth that mandatory testing and mandatory disclosure of HIV status of patients and/or nurses is a method to prevent the transmission of HIV disease, and therefore does not advocate mandatory testing or mandatory disclosure of HIV status. ANA supports the availability of voluntary anonymous or confidential HIV testing which is conducted with informed consent and pre- and post-test counseling. ANA continues to support education regarding the transmission of HIV/AIDS and the use and monitoring of universal precautions to prevent HIV/AIDS transmission.
• Position Statement: Travel Restrictions for Persons with HIV/AIDS - 9/06/91
  Summary: The American Nurses Association (ANA) opposes the current U.S. State Department policy which imposes travel restrictions for visitors with HIV/AIDS. ANA believes this policy is discriminatory and infringes upon the rights and dignity of individuals with HIV/AIDS. Further, ANA supports the enactment of federal legislation to revoke the current travel restrictions.
• Position Statement: Guidelines for Disclosure to a Known Third Party About Possible HIV Infection - 4/04/91
  Summary: ANA supports the availability of voluntary and confidential partner notification services for HIV-seropositive individuals. ANA also endorses the concept of an ethical responsibility to disclose otherwise confidential information about probable HIV exposure when the patient fails to uphold his/her duty to protect others by preventing transmission of the infecting agent, but only when specific criteria have been met and documented. Partner notification should only be undertaken by a nurse or health care worker who is skilled in the biological and psychosocial aspects of HIV infection.