Changes to Documentation of Consent for HIV Tests
Effective Thursday February 21, 2013, there will be changes with regard to the consent process for ordering HIV-related tests.
Summary of changes:
- The process for consent and documentation of consent for HIV testing will be done when placing a HIV order in Epic.
- There is no longer a need to obtain a “HIV Pre-test Counseling Packet”.
- Please Note: This DOES NOT change how HIV testing for blood and body fluid exposures for employees is currently done. Please continue to obtain “Significant Exposure Packets” from the Department of Social Services.
These changes align with current state law requirements for HIV testing and UI HealthCare Policy, Policy Governing Human Immunodeficiency Virus (HIV) Education, Testing, Reporting and Confidentiality:
• For adults (18 years or older) able to consent: verbal consent must be obtained prior to testing. Written consent is not necessary for adult patients.
• For minors (less than 18 years old): Before undergoing HIV test, a minor must be informed that the legal guardian will be notified if the result is confirmed as positive. Minors must give written consent for HIV testing and treatment services. The consent form must note that that the legal guardian will be notified of confirmed positive results. The signed consent needs to be scanned into Epic. HIV orders in minors will all receive audit review to make sure proper written consent has been obtained and is scanned into the patient chart in Epic.
• For adults or minors unable to consent: The individual’s guardian may give consent. If the legal guardian cannot be located or is unavailable, a health care provider may authorize an HIV test when the test is necessary for diagnostic purposes to provide appropriate urgent medical care.
To meet these requirements the following changes are going into effect for all HIV-related tests in Epic:
(1) Prompt with hardstop: “As the ordering provider, I am documenting that I have met the requirements for HIV testing for this patient. (Note: Processing instructions below contain the specific requirements of Iowa law).”
LIP will need to document yes.
(2) Prompt with hardstop: “Please indicate mode of consent for the testing ordered on this patient.”
Drop down choices are:
1. Verbal consent
2. Written consent (required for minors unless for urgent medical reasons)
3. No consent needed – testing for diagnostic purposes for appropriate urgent care
LIP will need to select one choice.
(3) Epic orders for HIV-related tests will have hyperlinks to consent form (for minors) and to pre-education forms so that these forms are available if needed for a particular patient order.
Here are hyperlinks to these forms:
(4) These changes apply to the following tests in Epic:
HIV ANTIGEN/ANTIBODY COMBO (LAB7444)
HIV PHENOTYPING & GENOTYPING (LAB3335)
HIV QUANTITATIVE PCR (LAB2468)
HIV-1 GENOTYPING (LAB5745)
HIV-1 PROVIRAL DNA, QUAL PCR (LAB3339)
SALIVA RAPID HIV ½ ANTIBODY TEST (POC44)
UHL HIV ANTIBODY SCREEN (UHL37)
Questions should be directed to Matthew Krasowski, MD, PhD, Director of Clinical Laboratories (384-9380, matthew-krasowski@uiowa.edu) or Stephanie Holley, Infection Control and Prevention (356-0311, stephanie-holley@uiowa.edu).