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Henry SR, Hagedorn HJ, Feld JE, Golden JF, Horns HL, Knapp HE, Anaya HD. A formative evaluation of organizational readiness to implement nurse-initiated HIV rapid testing in two veterans health administration substance use disorders clinics. Journal of HIV/AIDS and Social Services. 2010 Jan 1; 9(1):7-26.
Dimensions for VA is a web-based tool available to VA staff that enables detailed searches of published research and research projects. Within the Veterans Health Administration (VHA), substance use disorder (SUD) clinics can be an important location for identifying HIV-infected patients. In this formative evaluation we assessed organizational readiness to implement a nurse-initiated HIV rapid test strategy in two VHA SUD clinics. We conducted 34 quantitative surveys and 21 key informant interviews with front-line staff and management to assess attitudes regarding HIV testing in general and nurse-initiated HIV rapid testing specifically. We also assessed potential organizational impediments and facilitators to the implementation of nurse-initiated HIV rapid testing. Staff agreed that nurse-initiated HIV rapid testing is supported by research evidence, clinical experience, and patient need. Staff differed on the degree to which nurse-initiated HIV rapid test strategy fit within the SUD clinic mission. We identified barriers to the implementation of nurse-initiated HIV rapid testing, including resource limitations, concerns of organizational readiness and patient acceptance of the nurse-initiated HIV rapid testing strategy. Despite these hurdles, the clinics are willing to adopt nurse-initiated HIV rapid testing if supported by appropriate modifications in organizational structure, HIV ordering policies and specific changes in clinical practices.
