ABSTRACT
Human immunodeficiency virus (HIV) tests are commonly performed in emergency departments (EDs) in the United States (US), but the experience and effectiveness of conducting rapid HIV tests in EDs in regions with low HIV seroprevalence outside the US have seldom been reported. An observational cross-sectional opt-in rapid HIV test and counseling program was conducted at an ED in a teaching hospital in Taiwan, a country with low seroprevalence, to determine the acceptance of rapid HIV tests as well as risky behaviors and illness presentations of people who agreed to undergo the tests. Among 7,645 ED patients between 20 and 55 years of age, 2,138 (28%) agreed to undergo rapid HIV tests, and only 2 (0.09%) tested positive. Patients diagnosed with urinary tract infections, respiratory tract infections, infectious diarrhea, and pelvic inflammatory disease were more likely to be willing to undergo rapid HIV tests in the ED. Stratified analysis revealed that sexually active patients were more likely to consent to HIV testing. Therefore, non-targeted opt-in HIV testing and counseling in the ED was feasible but was not effective in a region with low HIV seroprevalence.
Subject(s)
Emergency Medicine/methods , Emergency Service, Hospital , HIV Infections/diagnosis , Mass Screening/methods , Adult , Cross-Sectional Studies , Female , Hospitals, Teaching , Humans , Male , Middle Aged , Patient Acceptance of Health Care , Taiwan , Time Factors , Young AdultABSTRACT
Evidence-based practice has become a dominant trend in the healthcare with the objective of providing efficient, high quality health care, and policy making. Traditional problem-solving methods may not adequately address consumer needs in the rapidly changing modern healthcare system. In order to make correct decisions, a systematic and scientific approach to the collection, assessment, and interpretation of clinical information is essential for the health care provider. Creating an evidence-based practice nursing culture is the most fundamental way for nurses to recognize the importance of evidence-based nursing and, subsequently, adapt to solving clinical problems. This paper elaborates the strategy for incorporating evidence-based nursing into the clinical ladder system used at the authors' affiliated medical center. Three strategies are introduced. These are: (1) including the EBN concept in newcomer in-service training; (2) adopting evidence-based nursing practice competence as a criterion in the clinical ladder system, with various evidence-based, ladder-related reports required for promotion; and (3) providing support to nurses through centralized and decentralized education as well as individual consultation. The proposed strategy is provided as a practical reference for educators and policy makers working to foster evidence-based practice nursing cultures.
Subject(s)
Career Mobility , Evidence-Based Nursing , Clinical Competence , Humans , Quality of Health CareABSTRACT
Disasters, natural and man made, devastate individuals and society through severe injury, death, property damage, public health problems, and later psychological issues. Emergency nurses are often the first professionals to arrive at the scene of a disaster incident. As such, they must be equipped with knowledge and skills related to disaster management. Training for disaster preparedness has become an important trend for emergency nurses in order to respond immediately to various disasters and to crisis management needs. The purposes of this article were to (1) describe concepts, knowledge and skills related to disaster nursing and (2) describe the disaster nursing experience and training content / protocol of emergency nurses working at the National Cheng Kung University Hospital in Taiwan. Issues related to training, work assignments, practical training, and staff management are also discussed.
