Andrea:

At a systemic level I would think that each facility generally has its own infection 
control protocol.  It is also the facility's responsibility to ensure that such 
manuals and rules are available in an accessible place.  At least this is how it is 
expected to be *theoretically*.  However, if such a protocol exists and is kept in an 
accessible place it is the professional's (including student's) responsibility to 
acquaint themselves with the procedures to be followed for the prevention of possible 
infections, both from and to clients.  Often practicing professionals (more likely 
than not such professionals might be non-nurses or others who are not normally exposed 
to body fluids) may tend to
overlook such a protocol.  However, if the facility has adhered to its part of having 
an infection control protocol and keeping it in an accessible place, the facility's 
liability in such a circumstance is covered.  Unfortunately, the onus under such 
circumstances falls upon the professional involved.

More specifically, if you have concerns you should respond to them independently of 
any other professional, whether supervisor or not.  This is regardless whether you are 
a student or a practicing professional.  I have come across situations like this on 
many different occasions (Hep C etc.), including one as a student.  As a student my 
supervisor at the placement had initially been dismissive about methicillin resistant 
Staphylococcus aureus (MRSA) which affected one of the client's I was working with.  
However, I went ahead did my own research and implemented the controls that I could to 
protect myself (simple stuff avoiding contact with certain body areas of the client, 
handwashing after
contact).  I also mentioned it to other staff, but they didn't seem as concerned as I 
was.  Did I overreact, I don't think so.

Hope this helps,

Biraj

P.S.: Please don't flame me for implying that non-nursing health care professionals 
are likely to less careful.  I simply said that because nurses are more exposed to 
working with body fluids as a rule.

Andrea Joerding wrote:

> While on my fieldwork last week at an orthopedic and rehabilitation center here in 
>Missouri, I worked with a client who sustained a stab wound to his left hand. He was 
>4 weeks post-hand surgery. My fieldwork CI assigned me to work on scar massage with 
>him and tendon gliding exercises. Before working with him, I asked her if I should be 
>wearing gloves. She said that it was not necessary and told me not to worry about it, 
>since his scar was very well healed. I spoke to my friends after this incidence and 
>they said that it is common for hand OTs to not wear gloves with their patients. How 
>common is this and how at risk is someone when they don't wear gloves with a possibly 
>infectious person?
>
> Thanks ahead of time for any responses!!


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