Emergency Department Management of Occupational Exposures: Cost Analysis of Rapid HIV Test

2001 ◽  
Vol 22 (5) ◽  
pp. 289-293 ◽  
Author(s):  
J. Celeste Kallenborn ◽  
Timothy G. Price ◽  
Ruth Carrico ◽  
Audrey B. Davidson
Keyword(s):  
Emergency Department ◽  
Occupational Exposure ◽  
Treatment Protocol ◽  
Rapid Test ◽  
Retrospective Chart Review ◽  
Occupational Exposures ◽  
Elisa Test ◽  
Enzyme Linked Immunosorbent Assay ◽  
Hiv Test ◽  
Rapid Hiv Test

AbstractObjective:To compare costs for evaluation and treatment of a healthcare worker (HCW) experiencing an occupational exposure, using a rapid human immunodeficiency virus (HIV) test versus a standard enzyme-linked immunosorbent assay (ELISA) HIV test.Design:Retrospective chart review of all HCWs presenting to the emergency department (ED) for care of an occupational exposure over a 13-month period.Setting:A 404-bed university-based level 1 trauma center with an annual ED census of approximately 35,000.Participants:All HCWs experiencing an occupational exposure treated in the ED using a rapid HPV protocol were included in the analysis.Methods:A calculation of selected costs of the initial evaluation and treatment of patients whose evaluation included a rapid HIV test on the source patient were performed. A similar calculation was then made for these patients, had the standard ELISA test been used. Evaluated costs included laboratory tests, postexposure prophylactic medications, and estimated lost work time. Other costs were constant and were not included in the evaluation.Results:Total evaluated cost using the rapid HIV test as part of the evaluation and treatment protocol was $465.80 for 17 patients. Had the ELISA test been used instead of the rapid test, the total evaluated cost for the 17 patients would have been $5,965.81.Conclusions:When used as part of the evaluation and treatment of the HCW with an occupational exposure, the rapid HIV test results in substantial cost savings over the ELISA test.

Low Rate of False-Positive Results with Use of A Rapid HIV Test

2002 ◽  
Vol 23 (6) ◽  
pp. 335-337 ◽  
Author(s):  
Cassandra D. Salgado ◽  
Heidi L. Flanagan ◽  
Doris M. Haverstick ◽  
Barry M. Farr
Keyword(s):  
Enzyme Immunoassay ◽  
False Positive ◽  
Diagnostic System ◽  
Rapid Test ◽  
Occupational Exposures ◽  
High Rate ◽  
Negative Results ◽  
Hiv Test ◽  
Rapid Hiv Test ◽  
Positive Results

Background:Occupational exposure to human immunodeficiency virus (HIV) is an important threat to healthcare workers. Centers for Disease Control and Prevention guidelines recommend prompt institution of prophylaxis. This requires (1) immediate prophylaxis after exposure, pending test results that may take more than 24 hours in many hospitals; or (2) performance of a rapid test. The Single Use Diagnostic System (SUDS)® HIV-1 Test is used to screen rapidly for antibodies to HIV type 1 in plasma or serum, with a reported sensitivity of more than 99.9%. We used this test from January 1999 until September 2000, when it was withdrawn from the market following reports claiming a high rate of false-positive results.Methods:We reviewed the results of postexposure HIV testing during 21 months.Results:A total of 884 SUDS tests were performed on source patients after occupational exposures (883 negative results, 1 reactive result). The results of repeat SUDS testing on the reactive specimen were also reactive, but the results of enzyme immunoassay and Western blot testing were negative. A new specimen from the same patient showed a negative result on SUDS testing. This suggested a specificity of 99.9%. In the 4 months after SUDS testing was suspended, there was 1 false-positive result on enzyme immunoassay for 1 of 132 source patients (presumed specificity, 99.2%).Conclusion:Use of the SUDS test facilitated rapid and accurate evaluation of source specimens, obviating unnecessary prophylaxis.

scholarly journals 1294. Long-Term Impact of an HIV Testing Program on High-Risk HIV Screening in the Emergency Department

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S466-S466
Author(s):  
Jillian T Baron ◽  
Alexis Schwartz ◽  
Ebony Davis ◽  
Julie E Uspal ◽  
Brendan Kelly
Keyword(s):  
Emergency Department ◽  
High Risk ◽  
Hiv Testing ◽  
Retrospective Chart Review ◽  
Hiv Screening ◽  
Transmitted Infection ◽  
Testing Program ◽  
Sti Testing ◽  
Hiv Test ◽  
To Receive

Abstract Background Emergency Departments (EDs) are important sites for HIV testing. However, there is little guidance on how best to implement HIV testing in the ED. The purpose of this study was to evaluate HIV screening practices of high-risk individuals presenting to an ED in the absence (ED1) and in the presence (ED2) of an established HIV testing program within the same academic hospital. Methods We performed a retrospective chart review of all individuals 18 years or older presenting to either ED between January 1, 2016 and December 31, 2018. High-risk of HIV infection was determined by receipt of bacterial sexually transmitted infection (STI) testing for Neisseria gonorrhoeae or Chlamydia trachomatis. The primary outcome was receipt of any HIV test in the ED. Overall proportions of patients tested for HIV at the same time of STI testing were compared between sites by chi-square test. Predictors of HIV testing were analyzed by logistic regression. Results During the study period, 7,956 individuals received STI testing at ED1 and 10,815 received STI testing at ED2. The majority of individuals receiving STI testing at both sites were female, 81.2% at ED1 and 66.4% at ED2 (P <0.001). Only 4.0% of individuals received HIV testing at ED1 compared with 47.4% at ED2 (P <0.001). Individuals were significantly more likely to receive HIV testing at the time of STI testing in the ED with an HIV testing program (aOR 19.66, 95% CI 17.28–22.37). In the ED without an HIV testing program, individuals were more likely to receive HIV testing if they were male (aOR 3.57, 95% CI 2.78–4.55) and less likely if they were black (aOR 0.57, 95% CI 0.50–0.97). In the ED with an HIV testing program, individuals were more likely to receive HIV testing if they were male (aOR 2.17, 95% CI 1.92–2.44) and more likely if they were black (aOR 1.74, 95% CI 1.37–2.20). Conclusion Overall, the presence of an HIV testing program in the ED significantly increased the probability that individuals would receive an HIV test at the time of bacterial STI testing and mitigated disparities in care. The results of this study will help guide ongoing interventions to improve HIV screening among high-risk individuals in the emergency department. Disclosures All authors: No reported disclosures.

scholarly journals Comparative Analysis of the Analytical Sensitivity of ELISA Test System DIA®-SARS-CoV-2-Ag-R with Rapid Tests for Viral Antigen SARS-CoV-2 Detection

2021 ◽  
Vol 83 (3) ◽  
pp. 66-71
Author(s):  
А.Y. Horlov ◽  
◽  
V.H. Serdiuk ◽  
О.K. Kiselova ◽  
A.O. Shevchuk ◽  
...  
Keyword(s):  
Viral Antigen ◽  
False Negative ◽  
Medical Science ◽  
Rapid Test ◽  
Test System ◽  
Elisa Test ◽  
Enzyme Linked Immunosorbent Assay ◽  
Analytical Sensitivity ◽  
Rapid Tests ◽  
Positive Results

A novel coronavirus severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causes coronavirus disease (COVID)-19, that emerged as a major pandemic. SARS-CoV-2 was identified as a betacoronavirus. Nucleocapsid protein (NP) is evolutionary high protein homologies and solid structure protein for SARS-CoV-2 detection as opposed to other proteins, that aren`t reliable as a single viral antigen during diagnostics methods. The viral RNA can be detected from nasal and pharyngeal swabs and bronchoalveolar lavage samples by PCR assay. However, the wrong collection of samples can lead to false-negative diagnosis and have dangerous consequences at this stage of pandemic. One of efficient and accurate methodological approaches for the screening of pathogens are serological assays. Aim. Evaluation and comparison of the sensitivity of invented DIA®-SARS-CoV-2-Ag-R enzyme-linked immunosorbent assay (ELISA)-based test system and commercial rapid tests, which detect the viral antigen of SARS-CoV-2. Methods. We carried out a comparison of DIA®-SARS-CoV-2-Ag-R and existed commercial test systems, which are used to detect the antigen of SARS-CoV-2 virus. Rapid tests are intended for nasopharyngeal swabs, but we proposed a protein of our own manufacture – recombinant NP as a calibrator. The detection limit was calibrated by standard CFAR #100982 NIBSC, UK. We had determined levels of NP (1400, 900, 750, 640 and 280 pg/mL) that we used as a sample for the rapid tests. The COVID-19 Ag Rapid Tests were performed according to the manufactures instructions at room temperature. Results. DIA®-SARS-CoV-2-Ag-R detected 10 pg/mL of in-house standard of recombinant SARS-CoV-2 NP. The positive results were observed using 1400, 900, 750 pg/mL, while 640 and 280 pg/mL samples were performed as negative in ABBOTT-PanBio test. The rapid tests manufactured by МBU, BIOTIME, Core Technology, SD BIOSENSOR and Turklab showed positive results only in 1400 pg/mL concentration. NP of lower levels was detected as a negative sample. The LEPU MEDICAL test was evaluated as positive sample using 900 pg/mL. The rapid test manufactured by Green Cross Medical Science Corp. showed negative results for all levels of NP. It can mean that the sensitivity of test is lower and demands higher level of antigen to detect the presence of SARS-CoV-2. Conclusions. The study presented an excellent analytical sensitivity of DIA®-SARS-CoV-2-Ag-R against commercial Antigen rapid tests. Thus, invented ELISA test system can be recommended for widespread usage for detection and confirmation of acute stage of SARS-CoV-2 infection.

scholarly journals Análise da operacionalização da testagem rápida para o HIV realizada pelo enfermeiro

2020 ◽  
Vol 10 (29) ◽  
pp. 100-111
Author(s):  
Ilisdayne Thallita Soares da Silva ◽  
Dhyanine Morais de Lima ◽  
Wenysson Noleto dos Santos ◽  
Rebecca Stefany da Costa Santos ◽  
Harlon França de Menezes ◽  
...  
Keyword(s):  
Family Health ◽  
Rapid Test ◽  
Structured Interview ◽  
Reference Network ◽  
Health Strategy ◽  
Hiv Test ◽  
Rapid Hiv Test ◽  
Family Health Strategy ◽  
La Red ◽  
Anti Hiv

O estudo objetivou analisar os modos de operacionalização da testagem rápida para o HIV realizada pelo Enfermeiro na Estratégia Saúde da Família. Trata-se de estudo qualitativo com 13 Enfermeiros da Estratégia Saúde da Família da Paraíba. Os dados foram coletados de abril a junho de 2017 por meio de entrevista semiestruturada e analisados pela análise temática de Bardin e o fluxograma descritor. As categorias que emergiram a partir das entrevistas e agrupadas em etapas no fluxograma descritor foram: oferta do teste rápido anti-HIV; entrega do resultado e aconselhamento pré-teste; execução do teste rápido anti-HIV; aconselhamento pós-teste; e encaminhamento do paciente. Conclui-se que a necessidade da identificação do fornecimento adequado de kits de testagem, da ampliação da oferta do teste para a população em geral, e da interação entre as unidades e Rede de referência no Estado.Descritores: Enfermagem, Testes Sorológicos, Síndrome de Imunodeficiência Adquirida. Analysis of the operationalization of the rapid test for HIV carried out by the nurseAbstract: The aim of this study was to analyze the ways in which the nurse performed rapid testing for HIV in the Family Health Strategy. This is a qualitative study with 13 Nurses of the Paraíba Family Health Strategy. The data were collected from April to June 2017 through a semi-structured interview and analyzed by the thematic analysis of Bardin and the flowchart descriptor. The categories that emerged from the interviews and were grouped in stages in the flowchart descriptor were: rapid HIV test offer, delivery of the result and pre-test counseling; implementation of the rapid HIV test; post-test counseling; and patient referral. It is concluded that the need to identify the adequate supply of test kits, the expansion of the test offer to the general population, and the interaction between the units and reference network in the State.Descriptors: Nursing, Serologic Tests, Acquired Immunodeficiency Syndrome. Análisis de la operacionalización de la prueba rápida para el HIV realizado por el enfermeroResumen: El estudio objetivó analizar las formas de operacionalización de las pruebas rápidas para el HIV realizada por el enfermero en la Estrategia de Salud Familiar. Este es un estudio cualitativo con 13 enfermeras de la Estrategia de Salud Familiar de Paraíba. Los datos se recopilaron de abril a junio de 2017 a través de una entrevista semiestructurada y se analizaron mediante el análisis temático de Bardin y el flujograma descriptor. Las categorías que surgieron de las entrevistas y se agruparon en etapas en el flujograma descriptor fueron: oferta de prueba rápida de anti-HIV, entrega del resultado y asesoramiento previo a la prueba; ejecución de la prueba rápida de HIV; asesoramiento posterior a la prueba; y encaminamiento del paciente. Se concluye que la necesidad de identificar el suministro adecuado de kits de prueba, la expansión de la oferta de prueba a la población general y la interacción entre las unidades y la Red de referencia en el Estado.Descriptores: Enfermería, Pruebas Serológicas, Síndrome de Inmunodeficiencia Adquirida.

Prevalence and Overtesting of True Heparin-Induced Thrombocytopenia in a 591-Bed Tertiary Care, Teaching Hospital

2017 ◽  
Vol 34 (6) ◽  
pp. 464-471 ◽  
Author(s):  
Stephen Farley ◽  
Caitlyn Cummings ◽  
William Heuser ◽  
Shan Wang ◽  
Rose Calixte ◽  
...  
Keyword(s):  
New York ◽  
Tertiary Care ◽  
Retrospective Chart Review ◽  
Elisa Test ◽  
Serotonin Release ◽  
University Hospital ◽  
Enzyme Linked Immunosorbent Assay ◽  
Heparin Induced Thrombocytopenia ◽  
Release Assay ◽  
Hospital Stays

Heparin-induced thrombocytopenia type II (HIT) is a rare but potentially fatal antibody-mediated reaction to all forms of heparin (unfractionated heparin, low-molecular weight heparin, heparin flushes, and heparin-coated catheters), which can lead to HIT with thrombosis. Two tests commonly used to screen for HIT include the enzyme-linked immunosorbent assay (ELISA) and serotonin release assay (SRA). This is a retrospective chart review study conducted from January 1, 2013, through December 31, 2014, to estimate the rate of true HIT in critical care patients at Winthrop-University Hospital, located in Mineola, New York. Patients are classified as positive for HIT if both ELISA and SRA immunoassays are positive. We reviewed 507 heparin immunoassays, excluding 64 who had an inappropriate ELISA test sent due to no administration of heparin, enoxaparin, or heparin lock flush at this or previous hospital stays at Winthrop. Of the 443 heparin immunoassays, ELISA results were positive for 66 patients (15.1%), and only 11 (2.5%) patients had true cases of HIT with a 95% confidence interval of 1.3% to 4.4%. The 4T score for those with true HIT (median: 5.0) was statistically higher compared to those without true HIT (median: 2.0; P < .001). Despite guidelines in place, overtesting for HIT is still a prevalent issue.

scholarly journals Strengths and weaknesses of rapid hiv test implementation in a specialized center in Brazil

2018 ◽  
Vol 20 (5) ◽  
pp. 560-567
Author(s):  
Adolfo Pizzinato ◽  
Kátia Bones Rocha ◽  
Rodrigo De Oliveira-Machado ◽  
Fernanda Torres de Carvalho ◽  
Isadora Nogueira-Freire
Keyword(s):  
Health Care ◽  
Hiv Testing ◽  
Health Care Access ◽  
Health Care Professionals ◽  
Rapid Test ◽  
Service Users ◽  
Structured Interviews ◽  
Rapid Hiv Testing ◽  
Hiv Test ◽  
Rapid Hiv Test

Objective To analyze how health professionals and health service users assess counseling on Rapid HIV test, as well as its implementation, which started in Brazil in 2010, focusing on positive aspects, barriers, and limitations, and analyzing possible meanings that are given to STD and HIV/AIDS.Method Qualitative, exploratory, and descriptive research. Semi-structured interviews were administered to 27 service users and 14 health care professionals; a thematic analysis of the interviews was performed. The study was carried out in one of the first Counseling and Testing Centers (CTC) designed to implement Rapid HIV tests in Porto Alegre, Brazil.Results Positive aspects of Rapid HIV testing implementation included a reduced waiting time for obtaining the test results, better assistance provision, an increase in the number of service hours, personalized pre- and post-tests, and better prepared health care professionals regarding health care during counseling. Limitations included beliefs about the effectiveness of Rapid HIV testing, physical structure, bad publicity on this technology, and poor health care capacity. Likewise, there are some who oppose this type of test, since they believe rapid tests may not be effective.Conclusions Integrating the perspectives of health care professionals and users on this policy will favor future rapid test implementations in other CTCs, and increase health care access possibilities.

scholarly journals Performance of the nursing team in the rapid HIV tes

2020 ◽  
Vol 14 ◽  
Author(s):  
Lise Maria Carvalho Mendes ◽  
Leidiane Pereira de Sousa ◽  
Renata Simões Monteiro ◽  
Veridiana Barreto do Nascimento ◽  
Antonio Sabino da Silva Neto
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Rapid Test ◽  
Hiv Infections ◽  
Test Method ◽  
Primary Health ◽  
Hiv Test ◽  
Rapid Hiv Test ◽  
Nursing Team ◽  
Anti Hiv

Objetivo: identificar potencialidades e fragilidades da equipe de enfermagem no manejo de pacientes no teste rápido anti-HIV. Método: trata-se de um estudo quantitativo, descritivo, exploratório, com a equipe de enfermagem que atua na execução do teste rápido anti-HIV. Levantou-se amostragem censitária, totalizando seis enfermeiros e seis técnicos de enfermagem os quais responderam ao questionário sociodemográfico e sobre a realização do teste rápido. Resultados: observaram-se, como potencialidades, a realização de grupos educativos, a realização do aconselhamento pós-teste e a entrega de resultados de forma individual. Verificaram-se as seguintes fragilidades: ficha imprópria para a coleta de dados; execução de etapas do teste rápido por profissionais distintos; ambiguidade na execução do protocolo de recrutamento de parceiros e notificação compulsória; sentir-se inseguro para a realização do procedimento; sobrecarga de trabalho; restrição de horários de funcionamento das Unidades Básicas de Saúde. Conclusão: ressalta-se que as fragilidades visualizadas demonstram que não se trata de uma problemática exclusiva à atenção PVHA na perspectiva da Atenção Primária à Saúde, mas, também, a outras ações programáticas no âmbito da Política Nacional da Atenção Básica. Descritores: HIV; Infecções por HIV; Síndrome da Imunodeficiência Adquirida; Equipe de Enfermagem; Atenção Primária à Saúde; Diagnóstico Precoce.AbstractObjective: to identify the nursing team's strengths and weaknesses in the management of patients in the rapid HIV test. Method: this is a quantitative, descriptive, exploratory study, with the nursing team that works on the rapid HIV test. A census sampling was carried out, totaling six nurses and six nursing technicians who answered the sociodemographic questionnaire and the performance of the rapid test. Results: it was observed, as potentialities, the realization of educational groups, the realization of post-test counseling and the delivery of results individually. The following weaknesses were found: improper form for data collection; execution of rapid test steps by different professionals; ambiguity in the execution of the partner recruitment protocol and mandatory notification; feeling insecure to perform the procedure; work overload; restriction of opening hours of the Basic Health Units. Conclusion: it is emphasized that the weaknesses seen demonstrate that this is not an exclusive problem to PLWHA care from the perspective of Primary Health Care, but also to other programmatic actions within the scope of the National Primary Care Policy. Descriptors: HIV; HIV Infections; Acquired Immunodeficiency Syndrome; Nursing, Team; Primary Health Care; Early Diagnosis.ResumenObjetivo: identificar las fortalezas y debilidades del equipo de enfermería en el manejo de pacientes en la prueba rápida de VIH. Método: es un estudio cuantitativo, descriptivo, exploratorio, con el equipo de enfermería que trabaja en la prueba rápida de VIH. Se realizó un muestreo censal, con un total de seis enfermeros y seis técnicos de enfermería que respondieron el cuestionario sociodemográfico y el desempeño de la prueba rápida. Resultados: se observó, como potencialidades, la realización de grupos educativos, la consejería posterior a la prueba y la entrega de resultados individualmente. Se encontraron las siguientes debilidades: forma incorrecta para la recopilación de datos; ejecución de pasos de prueba rápidos por diferentes profesionales; ambigüedad en la ejecución del protocolo de reclutamiento de socios y notificación obligatoria; sentirse inseguro para realizar el procedimiento; sobrecarga de trabajo; restricción de los horarios de atención de las Unidades Básicas de Salud. Conclusión: se enfatiza que las debilidades observadas demuestran que este no es un problema exclusivo para la atención de las PVVS desde la perspectiva de la Atención Primaria de Salud, sino también para otras acciones programáticas dentro del alcance de la Política Nacional de Atención Primaria. Descriptores: VIH; Infecciones por VIH; Síndrome de Inmunodeficiencia Adquirida; Grupo de Enfermeira; Atención Primaria de Salud; Diagnóstico Precoz.

Sign in / Sign up

Export Citation Format

Share Document