Implementation of a bundle to improve HIV testing during hospitalization for people who inject drugs.
Implementation of a bundle to improve HIV testing during hospitalization for people who inject drugs.
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DOI：
10.1177/26334895231203410
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发表时间：
2023-01
影响因子：
--
通讯作者：
Wurcel, Alysse G.
中科院分区：
文献类型：
--
作者：
Grussing, Emily D.;Pickard, Bridget;Khalid, Ayesha;Smyth, Emma;Childs, Victoria;Zubiago, Julia;Nunez, Hector;Jung, Amanda;Morales, Yoelkys;Daudelin, Denise H.;Wurcel, Alysse G.
增加艾滋病毒检测对结束艾滋病毒流行至关重要。注射毒品者（PWID）是感染艾滋病毒的最高风险人群。塔夫茨医学中心先前的研究发现，住院PWID的HIV检测率较低。我们的研究小组旨在确定和克服障碍，住院艾滋病毒筛查PWID使用实施科学的方法。利益攸关方参与收集关于艾滋病毒检测的障碍和促进因素的观点。制定并实施了PWID护理包，其中包括（1）艾滋病毒筛查;（2）甲型、B和丙型肝炎检测和疫苗接种;（3）阿片类药物使用障碍药物;（4）纳洛酮处方。来自所有九个实施变革专家建议（ERIC）集群的战略指导了实施计划。在整个执行过程中收集了利益攸关方的反馈意见，并评估了执行结果的可接受性和可行性。总体而言，PWID对住院期间提供的艾滋病毒检测感到满意。临床医生指出，艾滋病毒检测的主要障碍是对同意要求的不适和困惑。许多接受调查的住院医生报告说，他们有时忘记了对PWID进行艾滋病毒检测。不过，总的来说，住院医师认为PWID包是有用的，不会分散其他患者护理责任。主要利益攸关方参与增加住院环境中的艾滋病毒检测，导致实施了一个可行和可接受的PWID包。应进一步调查住院PWID的捆绑循证护理要素。注射毒品的人（PWID）感染艾滋病毒的风险增加。艾滋病毒检测是阻止艾滋病毒传播的关键战略。我们的研究为所有入院的PWID患者提供了一系列服务和测试。该捆绑包包括艾滋病毒检测;甲型、B和丙型肝炎检测和疫苗接种;阿片类药物使用障碍的药物;以及可以逆转阿片类药物过量的药物Narcan的处方。然后，我们询问了医生和患者，他们对捆绑包的感觉如何，以及他们预测在住院期间将HIV检测扩展到PWID的任何障碍和促进因素。病人接受扩大艾滋病毒检测，住院医生认为这也很重要，是他们责任清单上一个可管理的补充。然而，最有可能被遗忘的部分是艾滋病毒检测。本研究为PWID住院期间的捆绑服务奠定了基础。我们还强调了未来探索的领域。
Increased HIV testing is essential to ending the HIV epidemic. People who inject drugs (PWID) are among the highest risk for HIV infection. Previous research at Tufts Medical Center identified low HIV testing rates in hospitalized PWID. Our research team aimed to identify and overcome barriers to inpatient HIV screening of PWID using implementation science methods. Stakeholders were engaged to gather perspectives on barriers and facilitators of HIV testing. A PWID care bundle was developed and implemented, which included (1) HIV screening; (2) hepatitis A, B, and C testing and vaccination; (3) medications for opioid use disorder; and (4) naloxone prescription. Strategies from all nine Expert Recommendations for Implementing Change (ERIC) clusters guided the implementation plan. Stakeholder feedback was gathered throughout implementation, and implementation outcomes of acceptability and feasibility were assessed. PWID overall felt comfortable with HIV testing being offered while hospitalized. Clinicians cited that the main barriers to HIV testing were discomfort and confusion around consenting requirements. Many resident physicians surveyed reported that, at times, they forgot HIV testing for PWID. Overall, though, resident physicians felt that the PWID bundle was useful and did not distract from other patient care responsibilities. Engagement of key stakeholders to increase HIV testing in an inpatient setting led to the implementation of a PWID bundle, which was feasible and acceptable. Bundling evidence-informed care elements for inpatient PWID should be investigated further. People who inject drugs (PWID) are at an increased risk of contracting HIV. HIV testing is a key strategy to stop the spread of HIV. Our study created a bundle of services and tests to offer to all PWID who were admitted to the hospital. The bundle included HIV testing; hepatitis A, B, and C testing and vaccination; medications for opioid use disorder; and prescription for Narcan, a medication that can reverse opioid overdose. We then asked doctors and patients how they felt about the bundle and any barriers and facilitators that they predicted for expanding HIV testing to PWID while admitted to the hospital. Patients were accepting of expanding HIV testing, and resident physicians felt it was important as well and was a manageable addition to their list of responsibilities. However, the most likely part of the bundle to be forgotten was HIV testing. This study lays the groundwork for bundling services for PWID while they are hospitalized. We also highlight areas for future exploration.
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影响因子：
4.2
作者：
Gonsalves GS;David Paltiel A;Thornhill T;Iloglu S;DeMaria A Jr;Cranston K;Monina Klevens R;Walensky RP;Warren JL
通讯作者：
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在南部农村州实施由急诊部门启动的丁丙诺啡治疗阿片类药物使用障碍。
影响因子：
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作者：
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通讯作者：
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影响因子：
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作者：
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