1. Think HIV : A Quality Improvement Project Promoting HIV Testing In A Clinical Assessment Unit Of A Large Teaching Hospital
- Author
-
McCarty, Dr Emma
- Abstract
Background: Numbers of new HIV cases diagnosed per year in Northern Ireland (N.I.) continue to rise, in contrast to the successful reduction of diagnoses in London in 2017. In 2016, 47% of new diagnoses were at a late stage. A review of late HIV diagnoses in N.I. in 2014, found that the N.I rate compared unfavourably with the UK, 59% vs 42%. Clinical indicator conditions were present in 84.4% prior to diagnosis. 57% had previous investigations for conditions that may have been due to undiagnosed HIV. Of the 76 new diagnoses -3 died, 31 had prolonged admissions. BHIVA, RCEM and NICE call for testing outside of GUM settings. They state all physicians should be competent and confident to offer an HIV test. Methods: THINK HIV was conceived as a QI project aimed at decreasing rates of late diagnosis by increasing appropriate HIV testing in CAU. The project delivered three tailored one-hour interactive educational workshops to address educational need, barriers to testing and misconceptions around HIV. These were coupled with the development of an inter-departmental HIV testing pathway. Triggers to encourage testing were used including a clinical and demographic indicators card, weekly run chart displaying outcomes (number of tests done) and posters highlighting the project. Results: An increase in HIV testing, from 0-1 test per week to a peak of 15. In 10 months of the project, there have been 3 diagnoses from 147 tests. Conclusion: Undiagnosed HIV positive patients are presenting with clinical and demographic indicators to our ED department. HIV testing of these patients is necessary and feasible, but barriers to testing exist both on the clinician and health system side. The THINK HIV approach is a successful strategy for empowering ED and CAU staff to offer a HIV test. Regional roll-out is being considered.
- Published
- 2017