Title: Collaborating to Support Hospitals in Implementing Rapid Testing in Labor and Delivery in Florida
1Collaborating to Support Hospitals in
Implementing Rapid Testing in Labor and Delivery
in Florida
- Shalewa Noel-Thomas, M.P.H.
- Florida/Caribbean AETC
Funded by Florida Department of Health, Bureau
of HIV/AIDS
2Optimal Factors for Rapid Testing Implementation
3Optimal Factors for Rapid Testing Implementation
- Florida Legislation
- Perinatal HIV Prevention Funding
- Epidemiology
- Existing perinatal HIV prevention project
- Contract from the Florida Department of Health
- Initial stages of developing a Rapid Testing
Initiative - Florida Department of Health, Bureau of HIV/AIDS
- Florida/Caribbean AETC
4Florida Legislation
- Any pregnant women who appears at delivery with
no record of a blood test for HIV must be
counseled and offered an HIV test. -
-
Florida Administrative Code Ch.64D-3.019
5Epidemiology
- High incidence of perinatal HIV disease
- Ranked second in number of pediatric AIDS cases
reported in 2004 - 95 were perinatally acquired
- Only 60 of mothers of perinatal HIV/AIDS cases
knew their status prior to birth
6Role of the Florida/Caribbean AETC
- Florida/Caribbean AIDS Education and Training
Centers pre-workshop involvement - Identified hospitals
- Highly affected areas
- Established training relationships
- Readiness for implementation
- Provided contact information for key players
7Role of the Florida/Caribbean AETC
- During the workshop
- Provided information on Florida/Caribbean AIDS
Education and Training Centers training,
technical assistance, and resources.
8Role of the Florida/Caribbean AETC
- Post-workshop activities
- Consistently followed-up with each hospital to
determine their progress with implementation - Developed and provided resources
- Rapid Testing binder samples of Florida specific
policies and procedures, counseling flip charts,
HIV consent templates, information on rapid
tests, DOH letter supporting implementation, ACOG
opinion, MIRIAD findings, referrals for mother
and babies. - Educational brochures for providers and patients
- Pocket treatment guidelines
9What we did after the workshop.
- Workshop provided framework for the roll-out of a
statewide rapid testing implementation
initiative. - Developed framework for training
- Statewide Rapid Testing coordinator
- Three regional perinatal trainers
- Program coordinator
- Divided the state into 3 distinct training
regions - Regional trainers assigned to different areas
10(No Transcript)
11Objectives
- Implement rapid testing in all birthing hospitals
and centers in Florida. - Provide hospital specific training, technical
assistance and resources to insure complete and
effective implementation of rapid testing. - Evaluate compliance with and adherence to a
hospital policy for rapid HIV testing in the
context of a continuing quality improvement
program.
12Methods
- A list of obstetrical hospitals and birthing
centers in the state of Florida was generated (N
146). - Hospitals contacted by telephone, e-mails, and
on-site visits. - Labor and Delivery
- Pharmacy
- Laboratory
- Key players meeting
13Methods
- Provide ongoing training, technical assistance
and support - On-site training
- Trained all labor and delivery/nursery staff (day
and evening shifts). - Policy and procedure development
- Problem solving (laboratory vs. point-of-care
testing) - Counseling and testing (role plays)
- Referrals for infected mothers and exposed babies
14Results
- Since December 2004, all OB hospitals and
birthing centers have been contacted about rapid
testing.
15Quality Assurance
16Evaluation
17Challenges
- Lack of response from labor and delivery staff
and/or administration. - Lack of consensus on what department is
responsible LD or laboratory. - Conflicting reports of rapid testing
implementation - LD staff unaware
- Staff turnover
- No perception of risk.
18Conclusion
- Continued collaboration between the
Florida/Caribbean AETC and the Florida Department
of Health. - Goal Continue to facilitate rapid testing
implementation in all OB units statewide.
19- Our website
- www.usfcenter.org/perinatal
Funded by Florida Department of Health, Bureau
of HIV/AIDS