Influence of providers and nurses on completion of non-targeted HIV screening in an urgent care setting

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• 作者：Rachel A Bender Ignacio (17) (9)
  Jacqueline Chu (10)
  Melinda C Power (11)
  Jeffrey Douaiher (12)
  Jordan D Lane (13)
  Jeffrey P Collins (14) (15)
  Valerie E Stone (15) (16)
  
  17. Fred Hutchinson Cancer Research Center ; M1B-140 1100 Fairview Ave N ; Seattle ; WA ; 98109 ; USA
  9. Division of Allergy and Infectious Diseases ; University of Washington ; 1959 NE Pacific St ; BB545 ; 98195 ; Seattle ; WA ; USA
  10. Department of Medicine ; Massachusetts General Hospital ; Grey/Bigelow 740 ; 55 Fruit St ; 02114 ; Boston ; MA ; USA
  11. Department of Epidemiology ; Johns Hopkins Bloomberg School of Public Health ; 615 North Wolfe Street ; W6508 ; 21205 ; Baltimore ; MD ; USA
  12. Department of Surgery ; Johns Hopkins Hospital ; 600 N Wolfe St ; 21287 ; Baltimore ; MD ; USA
  13. Harvard Medical School ; Tosteson Medical Education Center ; 260 Longwood Ave ; 02115 ; Boston ; MA ; USA
  14. Department of Medicine ; CHC Urgent Care ; Massachusetts General Hospital Chelsea Healthcare Center ; 151 Everett Ave ; 02150 ; Chelsea ; MA ; USA
  15. Department of Medicine ; Harvard Medical School ; 25 Shattuck St ; 02115 ; Boston ; MA ; USA
  16. Department of Medicine ; Mount Auburn Hospital ; 330 Mount Auburn Street ; 02138 ; Cambridge ; MA ; USA
  
• 关键词：HIV ; Screening ; Patient care ; Urgent care
• 刊名：AIDS Research and Therapy
• 出版年：2014
• 出版时间：December 2014
• 年：2014
• 卷：11
• 期：1
• 全文大小：1,128 KB
• 参考文献：HIV surveillance--United States, 1981-2008. MMWR Morb Mortal Wkly Rep 60: pp. 689
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  12. Massachusetts General Law Part I, Title XVI, Chapter 111, Session 2012: Chapter 84, 鈥淎n Act Increasing Screening for HIV鈥? Approved 27 April 2012. 鈥淧ublic Health鈥?Commonwealth of Massachusetts [neralLaws/PartI/TitleXVI/Chapter111" class="a-plus-plus">https://malegislature.gov/Laws/GeneralLaws/PartI/TitleXVI/Chapter111]
  13. Massachusetts General Law, Part I, Title XVI, Chapter 112 搂 12聽F. 鈥淩egistration of Certain Professions and Occupations鈥?Commonwealth of Massachusetts [neralLaws/PartI/TitleXVI/Chapter112/Section12F" class="a-plus-plus">https://malegislature.gov/Laws/GeneralLaws/PartI/TitleXVI/Chapter112/Section12F]
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• 刊物主题：Infectious Diseases; Virology;
• 出版者：BioMed Central
• ISSN：1742-6405

文摘

Introduction Despite recommendations by the Centers for Disease Control (CDC) that all adults be offered non-targeted HIV screening in all care settings, screening in acute-care settings remains unacceptably low. We performed an observational study to evaluate an HIV screening pilot in an academic-community partnership health center urgent care clinic. Methods We collected visit data via encounter forms and demographic and laboratory data from electronic medical records. A post-pilot survey of perceptions of HIV screening was administered to providers and nurses. Multivariable analysis was used to identify factors associated with completion of testing. Results Visit provider and triage nurse were highly associated with both acceptance of screening and completion of testing, as were younger age, male gender, and race/ethnicity. 23.5% of patients completed tests, although 36.0% requested screening; time constraints as well as risk perceptions by both the provider and patient were cited as limiting completion of screening. Post-pilot surveys showed mixed support for ongoing HIV screening in this setting by providers and little support by nurses. Conclusions Visit provider and triage nurse were strongly associated with acceptance of testing, which may reflect variable opinions of HIV screening in this setting by clinical staff. Among patients accepting screening, visit provider remained strongly associated with completion of testing. Despite longstanding recommendations for non-targeted HIV screening, further changes to improve the testing and results process, as well as provider education and buy-in, are needed to improve screening rates.