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NPEP: Past 12 months

Non-occupational Post-exposure Prophylaxis (NPEP) Masonic Centre, Sydney October 2002. NPEP: Past 12 months. Australian National NPEP guidelines: status quo Basic science and NPEP: status quo Clinical studies: very little. NPEP: Past 12 months cont.

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NPEP: Past 12 months

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  1. Non-occupational Post-exposure Prophylaxis (NPEP) Masonic Centre, Sydney October 2002

  2. NPEP: Past 12 months • Australian National NPEP guidelines: status quo • Basic science and NPEP: status quo • Clinical studies: very little

  3. NPEP: Past 12 months cont.. • Conceptual changes to delivery of NPEP • Locating and testing source is cost effective Greub, AIDS 2002 • Swiss study NPEP • 76 cases where exposure source status unknown • Located and tested 33/76 sources • 24/33 (72%) sources tested HIV negative and NPEP avoided

  4. NPEP: Past 12 months cont.. • Conceptual changes to delivery of NPEP • NPEP: just don’t prescribe it • 5/27 European countries had NPEP guidelines Rey, AIDS Care 2000 • 13/27 countries never recommend NPEP • NPEP: take it with you just in case • NPEP: take it before you engage in sex

  5. Providing NPEP after hours • Alfred Hospital • ID clinic sees NPEP requests in business hours • ED sees NPEP after hours with ID unit backup

  6. Working with Alfred ED: lessons • Understanding their world • Writing ED-friendly protocols • Triage nurse is critical link • Educating nurses and doctors • Ongoing • High turnover rate

  7. Working with Alfred ED: lessons • Ownership of who runs NPEP: ED or ID?? • How to follow-up complaints about triage system • Rarely in letter form: likelier to be in print • ED needs written complaints • Communications between ED and the ID unit for follow-up of patients

  8. Working with Alfred ED: lessons • ED and pharmacy • Clear and easy process to finding, choosing and recording the prescription of NPEP drugs • Maintaining communication between ED and ID unit vital • Involve ED colleagues in research initiatives and development of database

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