Assessing Barriers and Facilitators to Participation in a Nurse-Driven, Opt-Out HIV Screening Program in the Emergency Department.

IF 2.2 Q1 NURSING Global Qualitative Nursing Research Pub Date : 2024-11-01 eCollection Date: 2024-01-01 DOI:10.1177/23333936241292735
Jackson M C Montgomery, Alida Bouris, Kimberly A Stanford
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Abstract

Emergency department (ED) HIV screening is a key component of the strategy to end the HIV epidemic, reaching populations with limited access to care for screening and early diagnosis. Many screening programs rely primarily on participation from ED nurses; however, little is known about the factors affecting nurse participation in screening. Guided by the Consolidated Framework for Implementation Research, 20 semi-structured interviews were conducted with ED nurses to explore perceptions of HIV screening, barriers and facilitators to participation, and implementation insights. Nurses were categorized as either high adopters or low adopters based on the number of HIV tests ordered 3 months prior to interviews. The Stanford Lightning Report Method, a rapid qualitative analysis approach, was used to analyze field notes. All participants generally agreed that the ED was an appropriate location for screening and that frequent, multimodal education about screening was needed. Integration of screening into standard workflows, education about the public health impact of screening, and the use of peer champions and mentors were identified as important strategies to increase participation. By incorporating these findings into implementation strategies, EDs may be able to increase nurse participation in screening, addressing important health equity issues in HIV diagnosis.

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评估急诊科护士主导的选择性退出 HIV 筛查项目的参与障碍和促进因素。
急诊科(ED)HIV 筛查是终结 HIV 流行战略的一个关键组成部分,它可以为获得医疗服务有限的人群提供筛查和早期诊断服务。许多筛查项目主要依靠急诊科护士的参与;然而,人们对影响护士参与筛查的因素知之甚少。在实施研究综合框架的指导下,我们对急诊室护士进行了 20 次半结构式访谈,以探讨她们对艾滋病筛查的看法、参与的障碍和促进因素以及实施的见解。根据访谈前 3 个月的 HIV 检测订单数量,护士被分为高采用率和低采用率两类。斯坦福闪电报告法是一种快速定性分析方法,用于分析现场记录。所有参与者普遍认为,急诊室是进行筛查的合适场所,而且需要经常开展多模式的筛查教育。将筛查纳入标准工作流程、开展有关筛查对公共卫生影响的教育以及使用同伴支持者和指导者被认为是提高参与率的重要策略。通过将这些发现纳入实施策略,急诊室或许能够提高护士对筛查的参与度,从而解决艾滋病诊断中重要的健康公平问题。
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来源期刊
CiteScore
2.90
自引率
5.90%
发文量
41
审稿时长
12 weeks
期刊介绍: Global Qualitative Nursing Research (GQNR) is a ground breaking, international, peer-reviewed, open-access journal focusing on qualitative research in fields relevant to nursing and other health professionals world-wide. The journal specializes in topics related to nursing practice, responses to health and illness, health promotion, and health care delivery. GQNR will publish research articles using qualitative methods and qualitatively-driven mixed-method designs as well as meta-syntheses and articles focused on methodological development. Special sections include Ethics, Methodological Development, Advancing Theory/Metasynthesis, Establishing Evidence, and Application to Practice.
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