title: Differences Between Emergency Nurse Perception and Patient Reported Experience With an ED HIV and Hepatitis C Virus Screening Program.
abstract: BACKGROUND
  Nontargeted human immunodeficiency virus (HIV) screening and targeted hepatitis C virus (HCV) screening for selected high-risk patients (those born between 1945 and 1965 and those who report injection drug use) was integrated into our ED triage process and carried out by nurses. Determining whether emergency nurses accurately perceive what patients experience is important to know because staff misperceptions may pose a barrier to program adherence and sustainability.
  
  
  METHODS
  We performed a cross-sectional survey study of emergency nurses and patients to assess the accuracy of emergency nurses' perception of patient experience with the HIV/HCV screening program. Respondents evaluated their level of agreement using a 5-item Likert scale for 9 statements across 4 domains related to the patient experience with the screening process (satisfaction, sense of autonomy, sense of privacy, and comfort level).
  
  
  RESULTS
  Surveys were completed by 65 of the 153 eligible emergency nurses (42%). Of the 1040 patients approached, 610 (59%) were eligible, and 491 of the 610 eligible patients (80%) completed surveys. Across all domains, statistically significant differences were found between emergency nurse perception and patient report, P < .001. Emergency nurses perceived patients to be less satisfied with the screening program, more uncomfortable with being asked screening questions, more concerned about privacy issues, and less likely to feel that the decision to decline screening was autonomous than were patients.
  
  
  CONCLUSIONS
  Emergency nurses not only frequently misperceive how patients experience ED-based HIV/HCV screening, but these misperceptions are skewed toward the negative, representing a type of staff bias. Further research is recommended to determine if such misperceptions adversely affect implementation of screening.
authors.affiliation: Oakland, CA. Electronic address: daewhite@gmail.com.
authors.forename: Douglas A E
authors.initials: DA
authors.lastname: White
authors.affiliation: Oakland, CA.
authors.forename: Erik S
authors.initials: ES
authors.lastname: Anderson
authors.affiliation: Oakland, CA.
authors.forename: Sarah K
authors.initials: SK
authors.lastname: Pfeil
authors.affiliation: Oakland, CA.
authors.forename: Sarah E
authors.initials: SE
authors.lastname: Graffman
authors.affiliation: Oakland, CA.
authors.forename: Tarak K
authors.initials: TK
authors.lastname: Trivedi
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D002140:California; D003430:Cross-Sectional Studies; D016529:Emergency Nursing / Q000706:statistics & numerical data*; D004636:Emergency Service, Hospital; D005260:Female; D015658:HIV Infections / Q000175:diagnosis* / Q000523:psychology; D019538:Health Care Surveys / Q000706:statistics & numerical data; D006526:Hepatitis C / Q000175:diagnosis* / Q000523:psychology; D006801:Humans; D008297:Male; D009741:Nursing Staff, Hospital / Q000523:psychology / Q000706:statistics & numerical data; D017060:Patient Satisfaction / Q000706:statistics & numerical data*
keywords: Emergency department; HIV screening; Hepatitis C virus screening; Patient satisfaction