A Comparison of Parallel and Integrated Models for Implementation of Routine HIV Screening in a Large, Urban Emergency Department
A Comparison of Parallel and Integrated Models for Implementation of Routine HIV Screening in a Large, Urban Emergency Department
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DOI：
10.1177/00333549161310s111
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发表时间：
2016-01-01
影响因子：
3.3
通讯作者：
Shah, Bijal
中科院分区：
文献类型：
--
作者：
Hankin, Abigail;Freiman, Heather;Shah, Bijal
目标。本研究比较了在急诊科(ED)实施非定向HIV筛查的两种方法：(1)在急诊科护理的同时指定HIV咨询师进行筛查；(2)将护士筛查纳入患者分诊。使用每个项目前12个月的数据进行回顾性分析，以比较并行和综合筛查模型。平行筛查模型的数据是从艾滋病毒检测顾问收集的信息和电子病历(EMR)中提取的。综合筛查模型数据从电子病历中提取，并由艾滋病毒社会工作者在患者互动期间收集的数据补充。对于这两个项目，数据包括人口统计数据、艾滋病毒检测条件、检测接受或下降，以及检测结果。两个比例之间进行Z检验，以比较筛查频率和结果。在首12个月的平行筛查中，约有12万人次前往急症室接受爱滋病病毒测试，其中3,816宗(3%)接受爱滋病病毒测试，65宗(2%)新诊断为爱滋病病毒感染。在综合筛查的最初12个月中，111,738名患者在急诊室进行了分流，其中16,329名患者(15%)接受了测试，190例(1%)新诊断。与平行筛查相比，综合筛查导致艾滋病毒筛查的频率更高(每次ED患者就诊0.15次测试，而每次ED患者就诊0.03次测试，p
Objective. This study compared two approaches for implementation of non targeted HIV screening in the emergency department (ED): (1) designated HIV counselors screening in parallel with ED care and (2) nurse-based screening integrated into patient triage.Methods. A retrospective analysis was performed to compare parallel and integrated screening models using data from the first 12 months of each program. Data for the parallel screening model were extracted from information collected by HIV test counselors and the electronic medical record (EMR). Integrated screening model data were extracted from the EMR and supplemented by data collected by HIV social workers during patient interaction. For both programs, data included demographics, HIV test offer, test acceptance or declination, and test result. A Z-test between two proportions was performed to compare screening frequencies and results.Results. During the first 12 months of parallel screening, approximately 120,000 visits were made to the ED, with 3,816 (3%) HIV tests administered and 65 (2%) new diagnoses of HIV infection. During the first 12 months of integrated screening, 111,738 patients were triaged in the ED, with 16,329 (15%) patients tested and 190 (1%) new diagnoses. Integrated screening resulted in an increased frequency of HIV screening compared with parallel screening (0.15 tests per ED patient visit vs. 0.03 tests per ED patient visit, p