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A formative evaluation of organizational readiness to implement nurse-initiated HIV rapid testing in two veterans health administration substance use disorders clinics

Henry SR, Hagedorn HJ, Feld JE, Golden JF, Horns HL, Knapp HE, Anaya HD. A formative evaluation of organizational readiness to implement nurse-initiated HIV rapid testing in two veterans health administration substance use disorders clinics. Journal of HIV/AIDS and Social Services. 2010 Jan 1; 9(1):7-26.

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Abstract:

Within the Veterans Health Administration (VHA), substance use disorder (SUD) clinics can be an important location for identifying HIV-infected patients. In this formative evaluation we assessed organizational readiness to implement a nurse-initiated HIV rapid test strategy in two VHA SUD clinics. We conducted 34 quantitative surveys and 21 key informant interviews with front-line staff and management to assess attitudes regarding HIV testing in general and nurse-initiated HIV rapid testing specifically. We also assessed potential organizational impediments and facilitators to the implementation of nurse-initiated HIV rapid testing. Staff agreed that nurse-initiated HIV rapid testing is supported by research evidence, clinical experience, and patient need. Staff differed on the degree to which nurse-initiated HIV rapid test strategy fit within the SUD clinic mission. We identified barriers to the implementation of nurse-initiated HIV rapid testing, including resource limitations, concerns of organizational readiness and patient acceptance of the nurse-initiated HIV rapid testing strategy. Despite these hurdles, the clinics are willing to adopt nurse-initiated HIV rapid testing if supported by appropriate modifications in organizational structure, HIV ordering policies and specific changes in clinical practices.





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