An Evidence-Based Approach to Overcoming Nursing Barriers to HIV Screening in Pregnant Women
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For nearly 15 years the Centers for, Disease Control has recommended universal HIV testing on all pregnant women to reduce mother to child transmission (MTCT) of human immunodeficiency virus (HIV). Many states are addressing the problem of accomplishing perinatal HIV testing through the implementation of opt-out policies. Yet, pregnant women continue to arrive at labor and delivery units without HIV perinatal lab documentation. A pregnant woman's knowledge of her HIV antibody status will help her to make informed decisions about care for herself and her infant. Using Roger's Diffusion of Innovation framework, this paper describes a process that was implemented at a large Pacific Northwest hospital to assist nurses in the implementation of perinatal HIV status assessment, documentation, counseling for testing, and tracking of outcomes. Using computer based nursing instruction modules, forced electronic HIV status documentation, and a step-by-step nursing process algorithm, the 483-licensed bed, private hospital was able to increase HIV screening rates prior to birth from 60% to 95-97% within a two year time frame.