Consent Form Hiv Test Page 4
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42Operating Procedure 153-31
June 14, 2010
(2)
Counseling shall comply with the Model Protocol on Counseling and Testing for
County Health Departments and Registered Testing Programs (Attachment 2). Note: Florida
State Hospital Laboratory is a registered testing site with the Florida Department of Health and
only offers confidential testing.
(3)
A risk assessment to HIV/AIDS and other sexually transmitted diseases will be
completed on all admissions to Florida State Hospital. Upon completion of risk assessments,
HIV Antibody testing and counseling will be offered to all residents on admission. Consent will
be documented on Department of Health Form 1818 (page 1), Consent for Confidential Human
Immunodeficiency Virus (HIV) Test (Attachment 1).
(4)
Risk assessments for HIV/AIDS, sexually transmitted diseases (STD’s) will be
completed when indicated for:
(a)
residents who request testing;
(b)
residents/employees who have received a significant exposure to another
person infected with HIV/AIDS; and
(c)
residents with clinical symptoms of HIV/AIDS.
(5)
Residents who have risk factors for HIV, show clinical symptoms of AIDS or
acute HIV infection and refuse or are unable to grant informed consent will be evaluated by the
Unit Recovery Team. Administrative procedures may be initiated to obtain authority from the
legal guardian or courts to conduct the HIV antibody testing.
(6)
Any female resident who is pregnant on admission or becomes pregnant will be
counseled and offered an HIV test as required by Florida law (s.384.31). If the resident objects,
Department of Health Form 3161 (Attachment 3), is to be completed and placed in the
resident’s medical record. The test should be offered on admission to Florida State Hospital if a
previous test is unavailable and again at 28-32 weeks gestation.
(7)
HIV Pre and Post Test Counseling is to be documented on Florida State
Hospital Form 13, Immunization/Treatment Record--Communicable Diseases/Education Form,
and in the progress notes. (Attachment 4, page 2).
(8)
HIV Post Test counseling is to be completed as soon as possible after the Unit
receives the test results for residents (Attachment 5). The results and counseling must be
completed within five working days and documented in the medical record. If the resident’s
mental or physical condition is unstable and counseling is delayed, documentation should reflect
the rationale for the delay in the progress notes.
b.
Confidentiality of Test Results:
(1)
The results of HIV antibody tests are confidential and may not be publicly
disclosed except with the resident’s/employee’s written permission or as otherwise provided in
Chapter 384, Florida Statutes.
(2)
Confidential medical information including HIV antibody test results may only be
shared with employees of the department and its authorized representatives who are
responsible for the custody, medical care and treatment of Department of Children and Families
residential residents and who have a need to know such information.
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