Implementation of universal rapid human immunodeficiency virus screening on labor and delivery.

MedStar author(s):
Citation: Therapeutic Advances in Infectious Disease. 5(2):47-54, 2018 MarPMID: 29468056Institution: MedStar Health Research Institute | MedStar Washington Hospital CenterDepartment: Obstetrics and Gynecology/Maternal-Fetal MedicineForm of publication: Journal ArticleMedline article type(s): Journal ArticleSubject headings: IN PROCESS -- NOT YET INDEXEDYear: 2018ISSN:
  • 2049-9361
Name of journal: Therapeutic advances in infectious diseaseAbstract: Background: A case of mother to child transmission (MTCT) of HIV at a medical center in Washington, DC, resulted in the implementation of universal opt-out rapid testing of patients admitted for delivery. This article evaluates the policy's efficacy and implementation.Conclusion: The policy was successfully implemented with decreasing proportions of patients not tested. Earlier inclusion of testing into standard admission orders and nurse-based approach may have expedited adoption. Given the low incidence of new HIV diagnosis in labor, we were unable to assess decrease in MTCT.Methods: We evaluated the implementation using the Reach, Efficacy, Adoption, Implementation, and Maintenance (RE-AIM) framework.Results: We could not evaluate decrease in MTCT rate secondary to low sample size (n=3324) and no true-positive results. Patients not tested (n=458) were predominately secondary to physician omission (93.7%) and were more likely to be White (p<0.01) and older (p<0.01). There was a negative relationship with physician omission over time.All authors: Crochet S, Fries M, Huang CC, Scott RKFiscal year: FY2018Digital Object Identifier: ORCID: Date added to catalog: 2018-02-28
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Journal Article MedStar Authors Catalog Article 29468056 Available 29468056

Background: A case of mother to child transmission (MTCT) of HIV at a medical center in Washington, DC, resulted in the implementation of universal opt-out rapid testing of patients admitted for delivery. This article evaluates the policy's efficacy and implementation.

Conclusion: The policy was successfully implemented with decreasing proportions of patients not tested. Earlier inclusion of testing into standard admission orders and nurse-based approach may have expedited adoption. Given the low incidence of new HIV diagnosis in labor, we were unable to assess decrease in MTCT.

Methods: We evaluated the implementation using the Reach, Efficacy, Adoption, Implementation, and Maintenance (RE-AIM) framework.

Results: We could not evaluate decrease in MTCT rate secondary to low sample size (n=3324) and no true-positive results. Patients not tested (n=458) were predominately secondary to physician omission (93.7%) and were more likely to be White (p<0.01) and older (p<0.01). There was a negative relationship with physician omission over time.

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