HIV testing on Baker Act patient who is unable to give consent?

[Lola77]

I had a patient the other day who has schizophrenia and was Baker Act because he was found on the streets acting oddly/aggressive. He was found to have an infection and was in the hospital to get IV ABX. When I received report I was told that an HIV test was ordered, but wasn't done because patient is unable to give consent. He had no family. I drew blood for other labs, but also did not draw the HIV because he couldn't consent. I asked other nurses and my charge nurse what I should do/if i could draw the HIV test because he was a Baker Act but nobody knew. Then, my day got busy and I forgot all about it.

Could I have drawn the HIV testing blood without a consent since the patient was not able to consent/make his own decisions? (patient was not oriented at all - he thought he was a vampire)

Thanks for your input.

[bittybritty]

I know that in California we now do not require consent for HIV testing.

[Lola77]

I am in Florida and we still do. . .

[Boog'sCRRN246, RN]

This is from Title XXIX, chapter 381, statute 381.004 regarding HIV testing and informed consent in Florida...

"b) Except as provided in paragraph (h), informed consent must be obtained from a legal guardian or other person authorized by law when the person:

1. Is not competent, is incapacitated, or is otherwise unable to make an informed judgment"

[dudette10, MSN, RN]

This is from Title XXIX, chapter 381, statute 381.004 regarding HIV testing and informed consent in Florida...

"b) Except as provided in paragraph (h), informed consent must be obtained from a legal guardian or other person authorized by law when the person:

1. Is not competent, is incapacitated, or is otherwise unable to make an informed judgment"

But what does paragraph (h) say? That's the exception to the language you just posted.

[caroladybelle, BSN, RN]

What was the reason for needing HIV results?

(It is one thing if the pt has injured someone or there has been a needlestick, but another if there is no really good reason. Though I suspect if the pt has been drinking blood, or permitting others to drink his blood - a court might order it).

[Boog'sCRRN246, RN]

The OP was asking about obtaining consent for HIV testing from a person who was deemed incompetent to make decisions...In those cases, a legal guardian or other legally authorized person would have to be called upon to give consent for the testing. Here is part of paragraph (h)...

"h) Notwithstanding the provisions of paragraph (a), informed consent is not required:

1. When testing for sexually transmissible diseases is required by state or federal law, or by rule including the following situations:

a. HIV testing pursuant to s. 796.08 of persons convicted of prostitution or of procuring another to commit prostitution.

b. HIV testing of inmates pursuant to s. 945.355 prior to their release from prison by reason of parole, accumulation of gain-time credits, or expiration of sentence.

c. Testing for HIV by a medical examiner in accordance with s. 406.11.

d. HIV testing of pregnant women pursuant to s. 384.31.

2. Those exceptions provided for blood, plasma, organs, skin, semen, or other human tissue pursuant to s. 381.0041.

3. For the performance of an HIV-related test by licensed medical personnel in bona fide medical emergencies when the test results are necessary for medical diagnostic purposes to provide appropriate emergency care or treatment to the person being tested and the patient is unable to consent, as supported by documentation in the medical record. Notification of test results in accordance with paragraph © is required."

The entire statute is rather lengthy but here is a link (hopefully it works)

http://www.leg.state.fl.us/statutes/index.cfm?mode=View%20Statutes&SubMenu=1&App_mode=Display_Statute&Search_String=381.004&URL=CH0381/Sec004.HTM

[dudette10, MSN, RN]

Thank you for posting that. I had no idea what the paragraph h stated, but it was an exception...it just may not apply to the OP's patient.:)