Implementation of a Rapid Oral HIV Screening Initiative in a Pediatric Emergency Department

2.50
Hdl Handle:
http://hdl.handle.net/10755/162571
Type:
Presentation
Title:
Implementation of a Rapid Oral HIV Screening Initiative in a Pediatric Emergency Department
Abstract:
Implementation of a Rapid Oral HIV Screening Initiative in a Pediatric Emergency Department
Conference Sponsor:Emergency Nurses Association
Conference Year:2010
Author:Kingsnorth, Jennifer, RN, MSN
P.I. Institution Name:Children's National Medical Center
Title:Professional Practice Specialist
Contact Address:112 Michigan Avenue NW, Washington, DC, 20011, USA
Contact Telephone:202-476-3683
Co-Authors:Natella Rakhmanina, MD, FAAP, AAHIVS
Leadership Conference - Evidence-Based Practice Abstract: Implementation of a Rapid Oral HIV Screening Initiative in a
Pediatric Emergency Department

Purpose: In 2006 the CDC released a recommendation stating all health-care settings should provide routine HIV screening for all patients age 13-64. In response to the CDC the Emergency Department (ED) at CNMC evaluated the number of adolescent patient visits per year and compared the volume against the number of patients/families surveyed in our ED who stated they would agree to test. The results showed feasibility in the continuance of the development of an HIV screening program. Models of program development were evaluated at several hospitals currently providing HIV screening, to find no consensus. To date few pediatric emergency departments offer HIV screening.

Design: This evidence based practice implementation was designed to implement Oral HIV Screening into a pediatric emergency department meeting the needs of the adolescent patient population..

Setting: A pediatric emergency department in an urban mid-Atlantic region serving approximately 80,000 patients per year. Of the 80,000 patients, over 15,000 are over the age of 13 years.

Participants/Subjects: All patients age 13 years or older presenting to the emergency department are given the option of an Oral HIV test with the exception of patients with known HIV or AIDS infection, and patients with mental disability unable to provide self consent.

Methods: A multidisciplinary team consisting of, ED nurses ED physicians, Laboratory personnel, Infectious Disease and Adolescent Medicine physicians, and Ryan White HIV Services was formed to design an HIV screening program unique to pediatrics, that would reach approximately 50% of the adolescent patients (13+ yrs) presenting to the ED. A key aspect of our program was sustainability in the absence of outside funding therefore an algorithm was constructed to utilize the skills of the ED nurse to run HIV oral screens in lieu of a grant funded position. The algorithm also delineated a course of action for any reactive test result including, a confirmatory blood test , immediate ED social work consult, notification to an on-call adolescent physician, and a follow up appointment in the Department of Adolescent Medicine within 24-36 hours. Every patient screened receives educational materials about HIV and its prevention.

Results/Outcomes: Routine screening of adolescent patients began in March 2009. To date over 500 adolescent patients have been tested, with 2 positive screens confirmed with further laboratory testing. A reporting system with the Department of Health has been developed.

Implications: The emergency departmentÆs high patient volume this program enables outreach to a significant portion of the communityÆs young adult population providing a strong outlet for an important public health message and opportunity to decrease the high prevalence of HIV infection in a metropolitan area.

Repository Posting Date:
27-Oct-2011
Date of Publication:
17-Oct-2011
Sponsors:
Emergency Nurses Association

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titleImplementation of a Rapid Oral HIV Screening Initiative in a Pediatric Emergency Departmenten_GB
dc.identifier.urihttp://hdl.handle.net/10755/162571-
dc.description.abstract<table><tr><td colspan="2" class="item-title">Implementation of a Rapid Oral HIV Screening Initiative in a Pediatric Emergency Department</td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Emergency Nurses Association</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">2010</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Kingsnorth, Jennifer, RN, MSN</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">Children's National Medical Center</td></tr><tr class="item-author-title"><td class="label">Title:</td><td class="value">Professional Practice Specialist</td></tr><tr class="item-address"><td class="label">Contact Address:</td><td class="value">112 Michigan Avenue NW, Washington, DC, 20011, USA</td></tr><tr class="item-phone"><td class="label">Contact Telephone:</td><td class="value">202-476-3683</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">jhinrich@cnmc.org</td></tr><tr class="item-co-authors"><td class="label">Co-Authors:</td><td class="value">Natella Rakhmanina, MD, FAAP, AAHIVS</td></tr><tr><td colspan="2" class="item-abstract">Leadership Conference - Evidence-Based Practice Abstract: Implementation of a Rapid Oral HIV Screening Initiative in a<br/>Pediatric Emergency Department<br/><br/>Purpose: In 2006 the CDC released a recommendation stating all health-care settings should provide routine HIV screening for all patients age 13-64. In response to the CDC the Emergency Department (ED) at CNMC evaluated the number of adolescent patient visits per year and compared the volume against the number of patients/families surveyed in our ED who stated they would agree to test. The results showed feasibility in the continuance of the development of an HIV screening program. Models of program development were evaluated at several hospitals currently providing HIV screening, to find no consensus. To date few pediatric emergency departments offer HIV screening.<br/><br/>Design: This evidence based practice implementation was designed to implement Oral HIV Screening into a pediatric emergency department meeting the needs of the adolescent patient population..<br/><br/>Setting: A pediatric emergency department in an urban mid-Atlantic region serving approximately 80,000 patients per year. Of the 80,000 patients, over 15,000 are over the age of 13 years. <br/><br/>Participants/Subjects: All patients age 13 years or older presenting to the emergency department are given the option of an Oral HIV test with the exception of patients with known HIV or AIDS infection, and patients with mental disability unable to provide self consent. <br/><br/>Methods: A multidisciplinary team consisting of, ED nurses ED physicians, Laboratory personnel, Infectious Disease and Adolescent Medicine physicians, and Ryan White HIV Services was formed to design an HIV screening program unique to pediatrics, that would reach approximately 50% of the adolescent patients (13+ yrs) presenting to the ED. A key aspect of our program was sustainability in the absence of outside funding therefore an algorithm was constructed to utilize the skills of the ED nurse to run HIV oral screens in lieu of a grant funded position. The algorithm also delineated a course of action for any reactive test result including, a confirmatory blood test , immediate ED social work consult, notification to an on-call adolescent physician, and a follow up appointment in the Department of Adolescent Medicine within 24-36 hours. Every patient screened receives educational materials about HIV and its prevention.<br/><br/>Results/Outcomes: Routine screening of adolescent patients began in March 2009. To date over 500 adolescent patients have been tested, with 2 positive screens confirmed with further laboratory testing. A reporting system with the Department of Health has been developed. <br/><br/>Implications: The emergency department&AElig;s high patient volume this program enables outreach to a significant portion of the community&AElig;s young adult population providing a strong outlet for an important public health message and opportunity to decrease the high prevalence of HIV infection in a metropolitan area.<br/><br/></td></tr></table>en_GB
dc.date.available2011-10-27T10:30:26Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-27T10:30:26Z-
dc.description.sponsorshipEmergency Nurses Associationen_GB
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