Implementation of HIV-exposures triage strategy in emergency departments to improve nurse-triage for HIV-exposures: A pre- and post-intervention period study
•Quality indicators improvement for HIV-exposures patients in the ED.•A prospective observational 3-years pre- and post-intervention study.•The implementation of rules for HIV exposure improved triage performance.•Simulation training reduced time to access to post exposure prophylaxis (PEP). Health...
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Veröffentlicht in: | International emergency nursing 2019-11, Vol.47, p.100786, Article 100786 |
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creator | Casalino, Enrique Kenway, Philippe Bouzid, Donia Goncalves, Suzanne Antoniol, Stephanie Radou, Lorene Choquet, Christophe Macaux, Michelle Ghazali, Daniel Aiham |
description | •Quality indicators improvement for HIV-exposures patients in the ED.•A prospective observational 3-years pre- and post-intervention study.•The implementation of rules for HIV exposure improved triage performance.•Simulation training reduced time to access to post exposure prophylaxis (PEP).
Health Education in the emergency department (ED) is one of the tasks that the HIV-exposure triage implementation needs to be considered. No triage training has been evaluated.
A prospective 3-years pre- and post-intervention study in an urban academic ED was realized. The intervention was a simulation-based training on triage rules for triage nurses. Triage is based on time between HIV-exposure and ED arrival (≤48 h: level 2 (urgent); ≥48 h: level 5 (non-urgent)).
A total of 2011 HIV-exposures were included; 15.1 per cent were well triaged in pre-intervention vs. 88 per cent in post-intervention period (P |
doi_str_mv | 10.1016/j.ienj.2019.100786 |
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Health Education in the emergency department (ED) is one of the tasks that the HIV-exposure triage implementation needs to be considered. No triage training has been evaluated.
A prospective 3-years pre- and post-intervention study in an urban academic ED was realized. The intervention was a simulation-based training on triage rules for triage nurses. Triage is based on time between HIV-exposure and ED arrival (≤48 h: level 2 (urgent); ≥48 h: level 5 (non-urgent)).
A total of 2011 HIV-exposures were included; 15.1 per cent were well triaged in pre-intervention vs. 88 per cent in post-intervention period (P < 0.0001). Among well-triaged patients as level 2, the post-exposure prophylaxis prescription rate increased from 30.5 to 57.6 per cent (P < 0.0001). Time interval quality indicators (minutes) were: ED arrival-Triage Nurse 10.9 ± 9.6 vs. 9.1 ± 4.8 (P < 0.0001), ED arrival-Physician 56.3 ± 26.0 vs. 49.9 ± 36.0 (P = 0.0001), and ED arrival to Post-exposure prophylaxis first-dose 86.9 ± 30.0 vs. 65.2 ± 42.0 (P < 0.0001).
These results suggest that time interval HIV-exposure to ED arrival can be used as a triage criterion. A continuous quality improvement program for PEP after HIV-exposure based on a nurse triage training program achieved the objectives of optimizing the triage performance by reducing the time to access the post-exposure prophylaxis first-dose.</description><identifier>ISSN: 1755-599X</identifier><identifier>EISSN: 1532-9267</identifier><identifier>EISSN: 1878-013X</identifier><identifier>DOI: 10.1016/j.ienj.2019.100786</identifier><identifier>PMID: 31488346</identifier><language>eng</language><publisher>England: Elsevier Ltd</publisher><subject>Chi-Square Distribution ; Emergency department ; Emergency services ; Female ; Health education ; HIV ; HIV exposure ; HIV Infections - diagnosis ; HIV Infections - psychology ; Human immunodeficiency virus ; Humans ; Intervention ; Life Sciences ; Male ; Middle Aged ; Nurses ; Occupational Exposure - adverse effects ; Post exposure prophylaxis ; Professional training ; Prospective Studies ; Quality indicators ; Quality management ; Simulation ; Simulation training ; Time Factors ; Triage ; Triage - methods ; Triage - trends</subject><ispartof>International emergency nursing, 2019-11, Vol.47, p.100786, Article 100786</ispartof><rights>2019 Elsevier Ltd</rights><rights>Copyright © 2019 Elsevier Ltd. All rights reserved.</rights><rights>Copyright Elsevier Science Ltd. Nov 2019</rights><rights>Attribution - NonCommercial</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c462t-6c80acd11189e663d2031cb0e091b5b9bd7f9ace3a3d817580d6afb12a5432bf3</citedby><cites>FETCH-LOGICAL-c462t-6c80acd11189e663d2031cb0e091b5b9bd7f9ace3a3d817580d6afb12a5432bf3</cites><orcidid>0000-0002-7538-3320 ; 0000-0003-0129-4322</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.ienj.2019.100786$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>230,315,781,785,886,3551,27929,27930,31004,46000</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31488346$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink><backlink>$$Uhttps://hal.science/hal-03489124$$DView record in HAL$$Hfree_for_read</backlink></links><search><creatorcontrib>Casalino, Enrique</creatorcontrib><creatorcontrib>Kenway, Philippe</creatorcontrib><creatorcontrib>Bouzid, Donia</creatorcontrib><creatorcontrib>Goncalves, Suzanne</creatorcontrib><creatorcontrib>Antoniol, Stephanie</creatorcontrib><creatorcontrib>Radou, Lorene</creatorcontrib><creatorcontrib>Choquet, Christophe</creatorcontrib><creatorcontrib>Macaux, Michelle</creatorcontrib><creatorcontrib>Ghazali, Daniel Aiham</creatorcontrib><title>Implementation of HIV-exposures triage strategy in emergency departments to improve nurse-triage for HIV-exposures: A pre- and post-intervention period study</title><title>International emergency nursing</title><addtitle>Int Emerg Nurs</addtitle><description>•Quality indicators improvement for HIV-exposures patients in the ED.•A prospective observational 3-years pre- and post-intervention study.•The implementation of rules for HIV exposure improved triage performance.•Simulation training reduced time to access to post exposure prophylaxis (PEP).
Health Education in the emergency department (ED) is one of the tasks that the HIV-exposure triage implementation needs to be considered. No triage training has been evaluated.
A prospective 3-years pre- and post-intervention study in an urban academic ED was realized. The intervention was a simulation-based training on triage rules for triage nurses. Triage is based on time between HIV-exposure and ED arrival (≤48 h: level 2 (urgent); ≥48 h: level 5 (non-urgent)).
A total of 2011 HIV-exposures were included; 15.1 per cent were well triaged in pre-intervention vs. 88 per cent in post-intervention period (P < 0.0001). Among well-triaged patients as level 2, the post-exposure prophylaxis prescription rate increased from 30.5 to 57.6 per cent (P < 0.0001). Time interval quality indicators (minutes) were: ED arrival-Triage Nurse 10.9 ± 9.6 vs. 9.1 ± 4.8 (P < 0.0001), ED arrival-Physician 56.3 ± 26.0 vs. 49.9 ± 36.0 (P = 0.0001), and ED arrival to Post-exposure prophylaxis first-dose 86.9 ± 30.0 vs. 65.2 ± 42.0 (P < 0.0001).
These results suggest that time interval HIV-exposure to ED arrival can be used as a triage criterion. A continuous quality improvement program for PEP after HIV-exposure based on a nurse triage training program achieved the objectives of optimizing the triage performance by reducing the time to access the post-exposure prophylaxis first-dose.</description><subject>Chi-Square Distribution</subject><subject>Emergency department</subject><subject>Emergency services</subject><subject>Female</subject><subject>Health education</subject><subject>HIV</subject><subject>HIV exposure</subject><subject>HIV Infections - diagnosis</subject><subject>HIV Infections - psychology</subject><subject>Human immunodeficiency virus</subject><subject>Humans</subject><subject>Intervention</subject><subject>Life Sciences</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Nurses</subject><subject>Occupational Exposure - adverse effects</subject><subject>Post exposure prophylaxis</subject><subject>Professional training</subject><subject>Prospective Studies</subject><subject>Quality indicators</subject><subject>Quality management</subject><subject>Simulation</subject><subject>Simulation training</subject><subject>Time Factors</subject><subject>Triage</subject><subject>Triage - methods</subject><subject>Triage - trends</subject><issn>1755-599X</issn><issn>1532-9267</issn><issn>1878-013X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>7QJ</sourceid><recordid>eNp9kU-r1DAUxYsovufTL-BCAq5cdMyfNk3EzfBQZ2DAjYq7kCa3Y8q0qUk6OB_G72pKxwduXCUcfufk5p6ieEnwhmDC3_YbB2O_oZjILOBG8EfFLakZLSXlzeN8b-q6rKX8flM8i7HHmBNO6dPihpFKCFbx2-L3fphOMMCYdHJ-RL5Du_23En5NPs4BIkrB6SOgmIJOcLwgN6KMhyOM5oIsTDqkxZ1Bj9wwBX8GNM4hQnl1dj78G_kObdEUoER6tChrqXRjgnDOKcsEEwTnbX5wtpfnxZNOnyK8uJ53xdePH77c78rD50_7--2hNBWnqeRGYG0sIURI4JxZihkxLQYsSVu3srVNJ7UBppkVeSkCW667llBdV4y2Hbsr3qy5P_RJTcENOlyU107ttge1aJhVQhJanUlmX69s_uvPGWJSvZ_DmMdTlNFGSIbFQtGVMsHHGKB7iCVYLe2pXi3tqaU9tbaXTa-u0XM7gH2w_K0rA-9XAPIyzg6CiianGLAugEnKeve__D93SK3X</recordid><startdate>20191101</startdate><enddate>20191101</enddate><creator>Casalino, Enrique</creator><creator>Kenway, Philippe</creator><creator>Bouzid, Donia</creator><creator>Goncalves, Suzanne</creator><creator>Antoniol, Stephanie</creator><creator>Radou, Lorene</creator><creator>Choquet, Christophe</creator><creator>Macaux, Michelle</creator><creator>Ghazali, Daniel Aiham</creator><general>Elsevier Ltd</general><general>Elsevier Science Ltd</general><general>Elsevier</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QJ</scope><scope>ASE</scope><scope>FPQ</scope><scope>K6X</scope><scope>NAPCQ</scope><scope>1XC</scope><scope>VOOES</scope><orcidid>https://orcid.org/0000-0002-7538-3320</orcidid><orcidid>https://orcid.org/0000-0003-0129-4322</orcidid></search><sort><creationdate>20191101</creationdate><title>Implementation of HIV-exposures triage strategy in emergency departments to improve nurse-triage for HIV-exposures: A pre- and post-intervention period study</title><author>Casalino, Enrique ; Kenway, Philippe ; Bouzid, Donia ; Goncalves, Suzanne ; Antoniol, Stephanie ; Radou, Lorene ; Choquet, Christophe ; Macaux, Michelle ; Ghazali, Daniel Aiham</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c462t-6c80acd11189e663d2031cb0e091b5b9bd7f9ace3a3d817580d6afb12a5432bf3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>Chi-Square Distribution</topic><topic>Emergency department</topic><topic>Emergency services</topic><topic>Female</topic><topic>Health education</topic><topic>HIV</topic><topic>HIV exposure</topic><topic>HIV Infections - diagnosis</topic><topic>HIV Infections - psychology</topic><topic>Human immunodeficiency virus</topic><topic>Humans</topic><topic>Intervention</topic><topic>Life Sciences</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Nurses</topic><topic>Occupational Exposure - adverse effects</topic><topic>Post exposure prophylaxis</topic><topic>Professional training</topic><topic>Prospective Studies</topic><topic>Quality indicators</topic><topic>Quality management</topic><topic>Simulation</topic><topic>Simulation training</topic><topic>Time Factors</topic><topic>Triage</topic><topic>Triage - methods</topic><topic>Triage - trends</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Casalino, Enrique</creatorcontrib><creatorcontrib>Kenway, Philippe</creatorcontrib><creatorcontrib>Bouzid, Donia</creatorcontrib><creatorcontrib>Goncalves, Suzanne</creatorcontrib><creatorcontrib>Antoniol, Stephanie</creatorcontrib><creatorcontrib>Radou, Lorene</creatorcontrib><creatorcontrib>Choquet, Christophe</creatorcontrib><creatorcontrib>Macaux, Michelle</creatorcontrib><creatorcontrib>Ghazali, Daniel Aiham</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Applied Social Sciences Index & Abstracts (ASSIA)</collection><collection>British Nursing Index</collection><collection>British Nursing Index (BNI) (1985 to Present)</collection><collection>British Nursing Index</collection><collection>Nursing & Allied Health Premium</collection><collection>Hyper Article en Ligne (HAL)</collection><collection>Hyper Article en Ligne (HAL) (Open Access)</collection><jtitle>International emergency nursing</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Casalino, Enrique</au><au>Kenway, Philippe</au><au>Bouzid, Donia</au><au>Goncalves, Suzanne</au><au>Antoniol, Stephanie</au><au>Radou, Lorene</au><au>Choquet, Christophe</au><au>Macaux, Michelle</au><au>Ghazali, Daniel Aiham</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Implementation of HIV-exposures triage strategy in emergency departments to improve nurse-triage for HIV-exposures: A pre- and post-intervention period study</atitle><jtitle>International emergency nursing</jtitle><addtitle>Int Emerg Nurs</addtitle><date>2019-11-01</date><risdate>2019</risdate><volume>47</volume><spage>100786</spage><pages>100786-</pages><artnum>100786</artnum><issn>1755-599X</issn><eissn>1532-9267</eissn><eissn>1878-013X</eissn><abstract>•Quality indicators improvement for HIV-exposures patients in the ED.•A prospective observational 3-years pre- and post-intervention study.•The implementation of rules for HIV exposure improved triage performance.•Simulation training reduced time to access to post exposure prophylaxis (PEP).
Health Education in the emergency department (ED) is one of the tasks that the HIV-exposure triage implementation needs to be considered. No triage training has been evaluated.
A prospective 3-years pre- and post-intervention study in an urban academic ED was realized. The intervention was a simulation-based training on triage rules for triage nurses. Triage is based on time between HIV-exposure and ED arrival (≤48 h: level 2 (urgent); ≥48 h: level 5 (non-urgent)).
A total of 2011 HIV-exposures were included; 15.1 per cent were well triaged in pre-intervention vs. 88 per cent in post-intervention period (P < 0.0001). Among well-triaged patients as level 2, the post-exposure prophylaxis prescription rate increased from 30.5 to 57.6 per cent (P < 0.0001). Time interval quality indicators (minutes) were: ED arrival-Triage Nurse 10.9 ± 9.6 vs. 9.1 ± 4.8 (P < 0.0001), ED arrival-Physician 56.3 ± 26.0 vs. 49.9 ± 36.0 (P = 0.0001), and ED arrival to Post-exposure prophylaxis first-dose 86.9 ± 30.0 vs. 65.2 ± 42.0 (P < 0.0001).
These results suggest that time interval HIV-exposure to ED arrival can be used as a triage criterion. A continuous quality improvement program for PEP after HIV-exposure based on a nurse triage training program achieved the objectives of optimizing the triage performance by reducing the time to access the post-exposure prophylaxis first-dose.</abstract><cop>England</cop><pub>Elsevier Ltd</pub><pmid>31488346</pmid><doi>10.1016/j.ienj.2019.100786</doi><orcidid>https://orcid.org/0000-0002-7538-3320</orcidid><orcidid>https://orcid.org/0000-0003-0129-4322</orcidid><oa>free_for_read</oa></addata></record> |
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subjects | Chi-Square Distribution Emergency department Emergency services Female Health education HIV HIV exposure HIV Infections - diagnosis HIV Infections - psychology Human immunodeficiency virus Humans Intervention Life Sciences Male Middle Aged Nurses Occupational Exposure - adverse effects Post exposure prophylaxis Professional training Prospective Studies Quality indicators Quality management Simulation Simulation training Time Factors Triage Triage - methods Triage - trends |
title | Implementation of HIV-exposures triage strategy in emergency departments to improve nurse-triage for HIV-exposures: A pre- and post-intervention period study |
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