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June 2012, Volume 42 Number 6 , p 14 - 15


  • Susan A. Salladay PhD, RN


I got a needle-stick injury yesterday. I followed hospital policy and procedure afterward, reporting the incident, informing my manager, and going to the occupational health department for treatment. Later, my manager and I spoke with the patient whose blood I'd been exposed to. She explained that, following facility policy, he'd be tested for HIV. He angrily protested, saying he couldn't possibly have HIV and that it was my fault he had to be tested. My manager responded that he'd already given his consent for testing when he signed the hospital's general consent form on admission.I felt conflicted as I listened. Ineed to know this patient's HIV status, but I also think my manager misled him. I learned in nursing school that a separate consent form is always required for HIV testing to protect patients' rights. How can I be fair to both my patient and myself?-C.I., MICH.In the past, testing for HIV without a patient's specific consent was considered a possible violation of the Fourth Amendment right to privacy. This may be what you learned in nursing school, but in 2006, the CDC revised its recommendation for HIV testing in healthcare settings to make HIV testing a routine part of healthcare. Consent for HIV screening is now incorporated into the general consent form for medical care so that separate written consent isn't required or recommended. The CDC's goal was to promote early detection and effective treatment of HIV, reduce the stigma sometimes associated with HIV testing, and encourage patients who are HIV-positive to adopt practices that reduce the risk of transmission.To make sure your patient's rights are protected during and after testing, you or your manager should review with him the information that he received about HIV testing as part of the general consent process and answer any questions about what he can expect now. For example, assure him that his healthcare provider will review the test results and explain them to him. Let him know when to expect

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