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PERINATAL HIV RAPID TESTING IMPLEMENTATION IN FLORIDA. PRTI in Florida July 30, 2004. FLORIDA. High Incidence of Perinatal HIV Disease Both Urban and Rural populations 205,580 births in 130 hospitals Geographically a long state HIV awareness low in some areas. Perinatal HIV Background.
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PERINATALHIV RAPID TESTING IMPLEMENTATIONIN FLORIDA PRTI in Florida July 30, 2004 Potter and Rivero
FLORIDA • High Incidence of Perinatal HIV Disease • Both Urban and Rural populations • 205,580 births in 130 hospitals • Geographically a long state • HIV awareness low in some areas Potter and Rivero
Perinatal HIV Background • Provide Public Awareness • CDC ACOG DOH ACFM CNM • JAMA Publication (MIRIAD Study) • University of Florida Report • HIV Testing & Treatment Practices Among OB Providers in Florida. • A Study of Hospital Policies & Practices. Potter and Rivero
Florida Statute • Any pregnant women who appears at delivery with no record of a blood test for HIV must be counseled and offered an HIV test. • Practitioners attending a pregnant women must provide counseling and offer HIV testing at initial visit and again at 28 to 32 weeks gestation regardless of risk behaviors. Potter and Rivero
What We Need To Succeed…. • Buy in from Key Players • Create Structure/Framework for Implementation & Evaluation • Commitment from CDC, DOH & AETC Potter and Rivero
Objectives 1. Develop on ongoing L&D/Postpartum/Nursery system for rapid HIV testing in each hospital in Florida with an Obstetrics service. 2. Provide hospital specific training and technical assistance in order to ensure complete effective implementation of rapid HIV testing across the state. 3. Evaluate adherence with hospital policy for rapid testing in the context of a continuing quality improvement program. Potter and Rivero
Implementation Plan • Phase I • Hospital Specific Needs Assessment. • Phase II • Implementation • Hospital Specific • Three Tiered Model • Sustainability • Phase III • Evaluation • Pilots • Implementation Outcomes Potter and Rivero
Phase I • Needs Assessment: • Meeting with Key Players • Key Player Questionnaire Potter and Rivero
Meeting with Key Players • CEO/CFO • VP Nursing • Maternal-Child Nursing Director • Laboratory Director • Chief of Staff OB/Nursery • Pharmacy Director • HIS/Computer Director (if appropriate) • Infectious/HIV-AIDS Medical Director • Risk Management Potter and Rivero
Phase II • Statewide Implementation framework. • Create a template for implementation • Which can be individualized by site as needed. • Regional Coordinators organize implementation per site and area region. Potter and Rivero
Legislation info. Pro’s of POC Data (articles, studies) HAART availability Rapid Test kit. Timeline Sample policy and procedures. Referral information Community resource list. Sample Forms Consents RT logs Data collection Implementation/Framework Potter and Rivero
Meet with key players L&D nursing staff, OB and Pediatric staff… Review existing protocols. Rapid Testing Training Slides Role plays Flip charts Data collection and surveillance forms Provide self-directed training materials Video Training packet Binder with sample forms and policies. Quality Assurance tools Implementation/Framework Potter and Rivero
HIV Counseling Flip Chart Potter and Rivero