Bloodborne and Other Infectious Agents

Respiratory Therapists have an ethical obligation to protect the public from any potential transmission of bloodborne pathogens and other infectious diseases. The College encourages all Members to take every possible precaution to prevent transmission of infection from themselves to their patients and others. It is the College’s position that:

Members must be vigilant and rigorously adhere to Routine Practices, Additional Precautions, and the use of Personal Protective Equipment (PPE) when required.³,⁴,⁵

Members providing direct patient care are encouraged to keep their immunizations up to date (e.g. Hepatitis, Influenza⁶, measles, mumps, rubella, Tuberculosis, and Varicella).

Members have an ethical obligation to know their serologic status with respect to bloodborne pathogens such as HIV and Hepatitis, although they are not obligated to disclose it to their patients⁷.

Members have an ethical obligation to know their status with respect to other infectious pathogens such as Tuberculosis and Varicella, although they are not obligated to disclose it to their patients.

Members who are positive for infectious pathogens should seek advice to assist with assessing the risk of transmitting infectious agents to others. The College may provide professional practice advice and links to resources (for example but not limited to, Public Health Ontario’s Infectious Diseases Programs and Services), aimed at assisting Members in making safe and ethical decisions regarding their practice.

Members who are positive for infectious pathogens (especially those who perform high risk, exposure-prone procedures⁸) should take all necessary precautions, including modifying their practice if necessary, to prevent transmission to others.

#3, #4 See Best Practices for Infection Prevention and Control Programs in Ontario In All Health Care Settings 3rd Edition (PIDEC, 2012) bp-ipac-hc-settings.pdf (publichealthontario.ca)

#5 See CRTO’s Clinical Best Practice Guideline Infection Control (2016) Layout 1 (crto.on.ca)

#6 Government of Canada. (2016) Immunization of workers: Canadian Immunization Guide – Canada.ca

#7 For Blood Borne Disease Surveillance Protocol for Ontario Hospitals (2018) Blood Borne Diseases Protocol (November 2018).pdf (oha.com)

#8 Clinical Infectious Diseases, Volume 41, Issue 1, 1 July 2005, Page 136 Clinical Infectious Diseases, Volume 41, Issue 1, 1 July 2005, Page 136, https://doi.org/10.1086/431928

Does an RT who is diagnosed with HIV have a duty to report that to their patients?

The RT does not have a legal obligation to routinely disclose their serologic status to patients to obtain informed consent for a procedure, because healthcare workers have the right to privacy and confidentiality of their own personal medical information. However, from a moral and professional obligation, all efforts must be made to protect the patient from any exposure or harm, potentially even altering their practice. Organizational policy may differ with respect to disclosure.

If a patient is exposed to the RT’s blood/bodily fluids at some point during treatment, proper follow-up through their organizational process must occur and the patient be informed of the nature of the exposure. Proper post-exposure testing, and treatment is required, although all attempts to protect the identity of the RT must be made.

FOOTNOTES

3. See Best Practices for Infection Prevention and Control Programs in Ontario In All Health Care Settings 3rd Edition (PIDAC, 2012) bp-ipac-hc-settings.pdf (publichealthontario.ca)

4. For Public Health Ontario/Provincial Infectious Disease Advisory Committee’s (PIDAC) Knowledge Products (2012) click here

5. See CRTO’s Clinical Best Practice Guideline Infection Prevention and Control (2011) Layout 1 (crto.on.ca)

6. “Annual influenza vaccination should be a condition of continued employment in, or appointment to, a health care organizations” (PIDAC, 2012, p.32)

7. For Blood Borne Diseases Surveillance Protocol for Ontario Hospitals (2018) Blood Borne Diseases Protocol (November 2018).pdf (oha.com)

8. Clinical Infectious Diseases, Volume 41, Issue 1, 1 July 2005, Page 136 Clinical Infectious Diseases, Volume 41, Issue 1, 1 July 2005, Page 136, https://doi.org/10.1086/431928