The Centers for Disease Control and Prevention (CDC) estimates 1 in 7 people living with Human Immunodeficiency Virus (HIV) are unaware of their status. In 2019, 106 new HIV cases were reported in the state of Wisconsin, with 60% occurring in the southeast region. Nurses, physicians and leaders with the Froedtert & MCW health network identified a need to make HIV testing a standard of care in the Froedtert Hospital Emergency Department. The goals and benefits of testing are to change public perceptions about testing and overcome stigma that may discourage patients from being tested; identify patients with a positive status and connect them with specialty care and treatment; improve health outcomes and reduce the number of new cases per year.
In July 2022, an interprofessional team of nurses, clinicians and physicians from emergency departments (ED) across the health system implemented a standard HIV screening process for adult patients using an opt out testing model. This is the first program of its kind in the state. It aligns with the recommendations for non-risk-based HIV screening set forth by the CDC and U.S. Preventive Services Task Force. Every patient between the ages of 18-64, regardless of risk factors, who gets their blood drawn in the ED and does not have an HIV diagnosis recorded in their chart, will be tested for HIV unless they opt out. Patients receive the results in the ED, through MyChart or from an infectious disease specialist after they are discharged.
After successful implementation, the team continued to evaluate this new standard of care from the patient and staff perspective to ensure their needs were met and rapid improvements could be made when appropriate. As a result, the initiative brought forth a better understanding of the stigma surrounding HIV testing and a positive diagnosis, as well as enabled the nurses and the care team to educate the community on the importance of getting tested. Since July 2022, Froedtert Hospital ED nurses have screened more than 67% of patients each week, facilitated testing for more than 10,000 patients and connected 21 HIV-positive patients with ongoing care.
