The Priority of Administering HIV Postexposure Prophylaxis in Cases of Sexual Assault in an Emergency Department.J Emerg Nurs 2018; 44(2):117-122.e1JE
Contracting the human immunodeficiency virus (HIV) is a genuine concern for sexually assaulted patients. Emergency departments are a place where sexually assaulted patients seek care, including treatment to prevent HIV. Prompt administration of nonoccupational postexposure prophylaxis is essential because of the time-sensitive nature of the medications. Quality improvement measures at an urban hospital revealed delays in administration of postexposure prophylaxis to these patients.
A forensic simulation course and checklist was developed for emergency departments to improve care for sexually assaulted patients. Data used for analysis included time of administration of nonoccupational postexposure medication and length of stay before and after intervention with the simulation course and checklist. Points of measurement included student t-test to assess any significant differences and regression analysis to determine associations.
When comparing differences between time of nonoccupational postexposure before and after intervention, there was a trend toward improving the time of administration, but it was not found to be significant. Before intervention, an association was found with sexually assaulted patients' lengths of stay and the time that nonoccupational postexposure medication was administered, with a regression equation of R2, 0.76. After intervention, this association was absent, with an R2 of 0.017.
Implementing a simulation course and checklist for emergency nurses in caring for sexually assaulted patients helps to improve the timeliness of administration of nonoccupational postexposure medications and resolve the association between the length of stay and time of administration of medication.