Influence of providers and nurses on completion of non-targeted HIV screening in an urgent care setting

Table 3 Reported reasons HIV screening not performed during urgent care visit

Reason screening not performed	Number (%)
Sums to > 100% with multiple responses	Number (%)
Visit-Based or Potentially Modifiable Factors	1294 (77.3)
Provider felt patient to not be at risk	60 (3.6)
Patient felt themselves to be at low risk	367 (21.9)
Provider did not offer	141 (8.4)
Visit Acuity or Lack of Time^†	135 (8.1)
Patient desired testing, deferred to future PCP visit	20 (1.2)
Pregnancy diagnosed: testing deferred to PNV	8 (1.1)
Patient or provider perceived cost of testing^‡	7 (0.42)
Patient felt too ill to test	4 (0.24)
Other reason not listed/lack of documentation^†	552 (33.0)
Patient-Based Factors	471 (28.1)
Patient reported testing in the last 12 months	332 (19.8)
Patient declined, no reason given	68 (4.1)
Patient reported testing > 12 mos prior	59 (3.5)
Previously known HIV+ status	8 (0.48)
Fear of needles	4 (0.24)
Total Patients Not Screened/Enrolled Patients	1674 (100%)

Abbreviations: PNV, Pre-Natal Visit.
^†135 visits documented high-acuity of visit on the study form as reason testing not performed, however EMR review showed that the vast majority of the 552 visits with “Other Reason Not Listed” were also visits of high acuity, but without provider documentation on the study form. Examples of “High-acuity visits” determined by EMR review included presentation with probable cardiac chest pain, asthma exacerbation, foreign body in the eye, or other visit requiring emergent medical interventions and/or ambulance transfer to Emergency Department. Most visits fitting the above description of “High-acuity” also had incomplete HIV screening documentation, presumably because of the urgency of the patient encounter.
^‡The Commonwealth of Massachusetts offers “universal” health care coverage. For those not already enrolled in the hospital-based safety net system, the vast majority of patients are enrolled following first contact with CHC and covered retroactively, including all lab testing associated with the visit. Despite education regarding this, a small number of providers and/or patients remained concerned about cost of testing.

ISSN: 1742-6405