title: Launching nurse-initiated HIV rapid testing in Veterans Affairs primary care: a comprehensive overview of a self-sustaining implementation.
abstract: Our objectives were to use foundational pilot findings to guide the implementation of an HIV rapid testing (RT) intervention at one Veterans Affairs outpatient clinic and to evaluate the success and sustainability of this intervention over the course of one year. Policy modifications were drafted and adopted to enable nurses to order, administer, interpret and document HIV RTs. Staff enrolled in a two-part training sessions designed to teach pre- and post-test counselling techniques and the mechanics of administering, interpreting and coding test results in the patients' medical records. They were subsequently evaluated on their efforts at: (1) increasing HIV RT, (2) sustaining this effort one year post-launch. Enabling nurses to carry out HIV RT resulted in a significant increase in not only HIV RT, but also HIV testing rates overall at this facility, measured over the first year of this implementation. Our findings indicate that targeted strategies, aimed at increasing HIV RT rates, worked to increase testing rates overall, and also, that our initial testing strategies were independently sustainable, which is in contrast to findings in the literature on implementation science.
authors.affiliation: Veterans Affairs Quality Enhancement Research Initiative for HIV and Hepatitis, Veteran Affairs Greater Los Angeles Health Services Research and Development Center of Excellence, VA Greater Los Angeles Healthcare System, CA, USA. Herschel.Knapp@va.gov
authors.forename: H
authors.initials: H
authors.lastname: Knapp
authors.forename: H D
authors.initials: HD
authors.lastname: Anaya
authors.forename: J E
authors.initials: JE
authors.lastname: Feld
authors.forename: T
authors.initials: T
authors.lastname: Hoang
authors.forename: M B
authors.initials: MB
authors.lastname: Goetz
mesh_terms: D057286:Electronic Health Records; D005260:Female; D015658:HIV Infections / Q000175:diagnosis* / Q000451:nursing*; D006293:Health Promotion / Q000379:methods; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods / Q000706:statistics & numerical data; D024802:Nurse's Role; D019095:Point-of-Care Systems; D012984:Software; D013997:Time Factors; D014481:United States; D014493:United States Department of Veterans Affairs; D058014:Veterans Health / Q000706:statistics & numerical data*