Nurse-Led Pilot Program Boosts HIV, Hepatitis C Diagnosis Rates

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Nurse-Led Pilot Program Boosts HIV, Hepatitis C Diagnosis Rates

People with HIV also need to check their hepatitis C status.

Today in the U.S., one out of seven people living with HIV isn’t aware of their status, and a staggering 50% of people living with hepatitis C have never been diagnosed.

Because emergency departments are often where the country’s most vulnerable populations seek primary care, they’re a perfect place to bolster screening rates for infectious diseases like HIV and hepatitis C.

In May 2017, the emergency department staff at Alta Bates Summit Medical Center in California launched a pilot program for opt-out screening, meaning all eligible emergency room patients would be tested unless they specifically declined.

A few months later, the nursing staff banded together and requested they be given the authority to screen patients as part of their routine assessment and intake process. Incorporating HIV and hepatitis C screening into their existing workflow would help get more patients diagnosed, the nursing staff reasoned.

“We’re already triaging people,” said Kara Vassily, RN, “so for us, this is another series of things we can do to get the rapid HIV and hepatitis C screening done.”

Hospital directors agreed, giving Vassily and her colleagues permission to implement a nursing standardized procedure for HIV and hepatitis C testing. Over 17 months, the nurses and other clinical staff screened 10,024 patients for HIV and 9,236 for hepatitis C, according to a Nov. 8 poster presentation at the 2018 Association of Nurses in AIDS Care conference in Denver, Colorado.

The opt-out system helped reduce stigma, Vassily explained. When “you just frame it in a non-judgmental way,” almost everyone participates, she said.

Ultimately, 47 patients were diagnosed with HIV, and 279 were diagnosed with chronic hepatitis C. The number of acute HIV infections exceeded expectations, with 52% of patients living with the virus displaying symptomatic acute HIV. Another surprise was the large number of young patients diagnosed with hepatitis C, a disease that is five times more likely to be found among members of the baby boom generation than any other age group.

Emergency department nurses found that 36% of patients diagnosed with chronic hepatitis C were born after 1965 — the cutoff year for the baby boom generation — offering more support for the theory that disease prevalence is growing in younger generations because of the opioid epidemic.

Read on: Nurse-Led Pilot Program Boosts HIV, Hepatitis C Diagnosis Rates

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