Summary

Impact of specialized training for emergency department nurses screening or undetected HIV infection: the “Urgències VIHgila” project experience

Emília Miró1-3, Òscar Miró2-4, Angèlica Varón5, Pepi Marrón6, Carmen Canóniga7, Pilar Salgado8, Alba Mola9, Inmaculada Castro10, Ramón Montoya11, Jordi Llaneras5, Alejandro Smithson6, Margarita Sotomayor7, Neus Robert8, Emma Picart9, Paul Salazar10, Alexis Rebollo11, Emili Gené3,12, Alberto Villamor2,3,13 (en representación del grupo de trabajo “Urgències VIHgila”)

Affiliation of the authors

1Enfermería, Hospital Universitari Vall d’Hebron, Barcelona, Spain. 2Facultad de Medicina y Ciencias de la Salud, Universitat de Barcelona, Spain. 3Societat Catalana de Medicina d’Urgències i Emergències (SoCMUE), Barcelona, Spain. 4Área de Urgencias, Hospital Clínic, IDIBAPS, Universitat de Barcelona, Barcelona, Spain. 5Servicio de Urgencias, Hospital Universitari Vall d’Hebron, Barcelona, Spain. 6Servicio de Urgencias, Fundació Hospital de l’Esperit Sant, Santa Coloma de Gramenet, Barcelona, Spain. 7Servicio de Urgencias, Hospital Moisés Broggi, Sant Joan Despí, Barcelona, Spain. 8Servicio de Urgencias, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, Spain. 9Servicio de Urgencias, Hospital de Santa Caterina, Salt, Girona, Spain. 10Servicio de Urgencias, Hospital Joan XXIII, Tarragona, Spain. 11Servicio de Urgencias, Hospital Universitari de Bellvitge, L’Hospitalet de Llobregat, Barcelona, Spain. 12Servicio de Urgencias, Hospital Parc Taulí, Sabadell, Barcelona, Spain. 13Dirección de Enfermería, Hospital Clínic, IDIBAPS, Barcelona, Spain.

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Miró E, Miró O, Varón A, Marrón P, Canóniga C, Salgado P, et al. Impact of specialized training for emergency department nurses screening or undetected HIV infection: the “Urgències VIHgila” project experience. Emergencias. 2024;36:188-96

Summary

Objectives.

To evaluate the impact of specialized training for nurses on selective screening for undetected HIV infection in the emergency department.

Methods.

The intervention group was comprised of 6 emergency departments that had been participating in a screening program (the “Urgències VIHgila” project) for at least 3 months. Nurses on all shifts attended training sessions that emphasized understanding the circumstances that should lead to suspicion of unidentified HIV infection and the need to order serology. Two studies were carried out: 1) a quasi-experimental pre-post study to compare the number of orders for HIV serology in each time period and measures of sensitivity, and 2) a case-control study to compare the changes made in the 6 hospitals where specialized training was provided (cases) vs 6 control hospitals in the HIV screening program where no training was given.

Results.

A total of 280 HIV serologies were ordered for the 81015 patients (0.3%) attended during the period before training; 331 serologies were ordered for the 79620 patients in the period after training (0.4%). The relative increase in serologies was 20.3% (95% CI, 2.9% to 34.5%; P = .022). The relative increase in measures of sensitivity ranged between 19% and 39%, consistent with the main comparison. Serologies in the control group decreased between periods, from 0.9% to 0.8%, indicating a relative decrease of 15.7% (95% CI, –25.1% to –6.2%; P = .001). The absolute number of patients tested in the training group was 0.2% higher in the training hospitals (95% CI, 0.11% to 0.31%; P < .001) than in the control hospitals.
Conclusion. Training nurses to screen for undetected HIV infection in the emergency department increased the number of patients tested, according to the pre-post and case-control comparisons.

 

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