• Pediatric emergency care · Oct 2023

    Seize the Opportunity: Increasing the HIV Screening Rate in Adolescents Presenting to a Community Pediatric Emergency Department.

    • Rashida M Shakir, Samir Doshi, Samantha Blakeslee, and Morgan Jessee.
    • From the Children's Hospital of Philadelphia at Virtua Mount Holly Hospital, Mount Holly, NJ.
    • Pediatr Emerg Care. 2023 Oct 1; 39 (10): 801806801-806.

    ObjectivesOur objective was to increase human immunodeficiency virus (HIV) screening in adolescents presenting to our community pediatric emergency department with symptoms suggestive of a sexually transmitted infection (STI) and who were being tested for gonorrhea and chlamydia. Specifically, we aimed to increase the monthly average proportion of adolescents concurrently screened for HIV in this target group from 11% to 50% in 6 months.MethodsWe identified barriers to HIV screening, focusing on physician-related challenges and adolescents' concerns about confidentiality. We designed interventions targeting these barriers and implemented them in plan-do-study-act cycles beginning in February 2020. We educated physicians and nurses about screening recommendations, emphasized a physician-conducted private interview during which confidential contact information could be obtained, and assured confidentiality on after visit summaries by removing STI results. We also provided regular feedback to physicians on the screening rate. In addition, we implemented an electronic health record quick order set and a documentation tool. Using a statistical process control chart, we measured the average monthly proportion of adolescents in the target group who were offered HIV screening or tested for HIV before and after interventions.ResultsA total of 140 adolescents in the target group presented to our pediatric emergency department from February 2020 through December 2021. After plan-do-study-act cycles, the average monthly screening rate increased to 80%.ConclusionsRaising physician awareness of HIV screening recommendations and the importance of conducting a private interview improved screening rates. Assuring adolescent minors of confidentiality in a private interview, removing STI results from the after visit summary, and obtaining confidential contact information were important measures to overcome confidentiality barriers.Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.

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