Identifying Barriers to Universal HIV Screening in Labor and Delivery Triage
ACOG ePoster. Verma K. 04/30/21; 321146; 962742
Dr. Kajal Verma
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Introduction: With the goal of adhering to current CDC and ACOG guidelines, universal opt-out HIV screening was implemented on Labor and Delivery (L&D) triage in April 2020. The purpose of this study is to identify pregnant patients needing HIV testing as per guidelines, and determine the barriers to accomplishing this for all patients.
Methods: IRB approval was obtained for this cross-sectional analysis. Patients who were eligible for HIV testing were identified and placed in a logbook where extensive data was recorded, focusing on potential barriers to the recommended HIV test being sent. Per hospital protocol, patients were screened only if receiving laboratory testing as part of their visit.
Results: Data was collected on 253 patients who qualified for this study from April to October 2020. 37.2% of patients had insufficient or no prenatal care. 48.6% of patients had the recommended HIV test sent, and all tests returned negative. For patients without HIV testing sent, 67.7% was because no other labs were drawn. Other reasons include: providers declined (26.9%), providers not informed (3.8%), and patients declined (1.5%). Stated reasons for the provider declining included 'patient already screened', 'patient not at risk', 'will screen in office', or 'other'.
Conclusion/Implications: Universal HIV screening is an effective method for decreasing the number of pregnant patients with unknown HIV status in our population, as many of our patients have no prenatal care. 123 patients had HIV testing sent. If we remove the requirement for obtaining laboratory testing, 88 more tests could have been sent. Provider education may also help.
Methods: IRB approval was obtained for this cross-sectional analysis. Patients who were eligible for HIV testing were identified and placed in a logbook where extensive data was recorded, focusing on potential barriers to the recommended HIV test being sent. Per hospital protocol, patients were screened only if receiving laboratory testing as part of their visit.
Results: Data was collected on 253 patients who qualified for this study from April to October 2020. 37.2% of patients had insufficient or no prenatal care. 48.6% of patients had the recommended HIV test sent, and all tests returned negative. For patients without HIV testing sent, 67.7% was because no other labs were drawn. Other reasons include: providers declined (26.9%), providers not informed (3.8%), and patients declined (1.5%). Stated reasons for the provider declining included 'patient already screened', 'patient not at risk', 'will screen in office', or 'other'.
Conclusion/Implications: Universal HIV screening is an effective method for decreasing the number of pregnant patients with unknown HIV status in our population, as many of our patients have no prenatal care. 123 patients had HIV testing sent. If we remove the requirement for obtaining laboratory testing, 88 more tests could have been sent. Provider education may also help.
Introduction: With the goal of adhering to current CDC and ACOG guidelines, universal opt-out HIV screening was implemented on Labor and Delivery (L&D) triage in April 2020. The purpose of this study is to identify pregnant patients needing HIV testing as per guidelines, and determine the barriers to accomplishing this for all patients.
Methods: IRB approval was obtained for this cross-sectional analysis. Patients who were eligible for HIV testing were identified and placed in a logbook where extensive data was recorded, focusing on potential barriers to the recommended HIV test being sent. Per hospital protocol, patients were screened only if receiving laboratory testing as part of their visit.
Results: Data was collected on 253 patients who qualified for this study from April to October 2020. 37.2% of patients had insufficient or no prenatal care. 48.6% of patients had the recommended HIV test sent, and all tests returned negative. For patients without HIV testing sent, 67.7% was because no other labs were drawn. Other reasons include: providers declined (26.9%), providers not informed (3.8%), and patients declined (1.5%). Stated reasons for the provider declining included 'patient already screened', 'patient not at risk', 'will screen in office', or 'other'.
Conclusion/Implications: Universal HIV screening is an effective method for decreasing the number of pregnant patients with unknown HIV status in our population, as many of our patients have no prenatal care. 123 patients had HIV testing sent. If we remove the requirement for obtaining laboratory testing, 88 more tests could have been sent. Provider education may also help.
Methods: IRB approval was obtained for this cross-sectional analysis. Patients who were eligible for HIV testing were identified and placed in a logbook where extensive data was recorded, focusing on potential barriers to the recommended HIV test being sent. Per hospital protocol, patients were screened only if receiving laboratory testing as part of their visit.
Results: Data was collected on 253 patients who qualified for this study from April to October 2020. 37.2% of patients had insufficient or no prenatal care. 48.6% of patients had the recommended HIV test sent, and all tests returned negative. For patients without HIV testing sent, 67.7% was because no other labs were drawn. Other reasons include: providers declined (26.9%), providers not informed (3.8%), and patients declined (1.5%). Stated reasons for the provider declining included 'patient already screened', 'patient not at risk', 'will screen in office', or 'other'.
Conclusion/Implications: Universal HIV screening is an effective method for decreasing the number of pregnant patients with unknown HIV status in our population, as many of our patients have no prenatal care. 123 patients had HIV testing sent. If we remove the requirement for obtaining laboratory testing, 88 more tests could have been sent. Provider education may also help.
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