Characterization of medical errors in initiation of postexposure prophylaxis in sexual assault victims in the emergency department

2004 ◽  
Vol 44 (4) ◽  
pp. S12-S13 ◽  
Author(s):  
B.N. Corwell ◽  
K. Brouhard ◽  
C.D. Tibbles
Keyword(s):  
Emergency Department ◽  
Sexual Assault ◽  
Medical Errors ◽  
Postexposure Prophylaxis ◽  
Assault Victims

scholarly journals 986. Improvement in Administration of HIV Post-Exposure Prophylaxis in the Emergency Department Following Sexual Assault

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S521-S522
Author(s):  
Jennifer R Silva-Nash ◽  
Stacie Bordelon ◽  
Ryan K Dare ◽  
Sherrie Searcy
Keyword(s):  
Emergency Department ◽  
Sexual Assault ◽  
Hiv Transmission ◽  
Post Exposure Prophylaxis ◽  
Intervention Period ◽  
Post Intervention ◽  
Post Exposure ◽  
Assault Victims ◽  
Exposure Prophylaxis

Abstract Background Nonoccupational post exposure prophylaxis (nPEP) following sexual assault can prevent HIV transmission. A standardized Emergency Department (ED) protocol for evaluation, treatment, and follow up for post assault victims was implemented to improve compliance with CDC nPEP guidelines. Methods A single-center observational study of post sexual assault patients before/after implementation of an ED nPEP protocol was conducted by comparing the appropriateness of prescriptions, labs, and necessary follow up. A standardized order-set based on CDC nPEP guidelines, with involvement of an HIV pharmacist and ID clinic, was implemented during the 2018-2019 academic year. Clinical data from pre-intervention period (07/2016-06/2017) was compared to post-intervention period (07/2018-08/2019) following a 1-year washout period. Results During the study, 147 post-sexual assault patients (59 Pre, 88 Post) were included. One hundred thirty-three (90.4%) were female, 68 (46.6%) were African American and 133 (90.4%) were candidates for nPEP. Median time to presentation following assault was 12.6 hours. nPEP was offered to 40 (67.8%) and 84 (95.5%) patients (P< 0.001) and ultimately prescribed to 29 (49.2%) and 71 (80.7%) patients (P< 0.001) in pre and post periods respectively. Renal function (37.3% vs 88.6%; P< 0.001), pregnancy (39.0% vs 79.6%; P< 0.001), syphilis (3.4% vs 89.8%; P< 0.001), hepatitis B (15.3% vs 95.5%; P< 0.001) and hepatitis C (27.1% vs 94.3%) screening occurred more frequently during the post period. Labratory, nPEP Prescription and Follow up Details for Patients Prescribed nPEP Conclusion The standardization of an nPEP ED protocol for sexual assault victims resulted in increased nPEP administration, appropriateness of prescription, screening for other sexually transmitted infectious and scheduling follow up care. While guideline compliance dramatically improved, further interventions are likely warranted in this vulnerable population. Disclosures Ryan K. Dare, MD, MS, Accelerate Diagnostics, Inc (Research Grant or Support)

The Epidemiology of Female Rape Victims Who Seek Immediate Medical Care

2004 ◽  
Vol 19 (1) ◽  
pp. 3-12 ◽  
Author(s):  
David J. Magid ◽  
Debra Houry ◽  
Thomas D. Koepsell ◽  
Andrew Ziller ◽  
Michael R. Soules ◽  
...  
Keyword(s):  
Emergency Department ◽  
Sexual Assault ◽  
Medical Care ◽  
Emergency Care ◽  
Annual Incidence ◽  
Surveillance Data ◽  
Rape Victims ◽  
Assault Victims

Women who seek medical care following sexual assault are usually evaluated and treated in an emergency department (ED). Therefore, EDs can be an important source of sexual assault surveillance data. The authors compared the incidence of sexual assault presenting for emergency care in a single county during July to November of 1974 and 1991. Participants included all female sexual assault victims aged 14 and older who presented for ED evaluation. Treating physicians prospectively collected data using standardized forms. The z statistic was used to compare sexual assault incidence. There was a 60% increase in the incidence of sexual assault victims presenting for emergency care in 1991 compared to 1974, primarily due to an increase in the incidence of women presenting to the ED after rapes by known assailants. In contrast, the annual incidence of reported stranger assaults was similar in the two study years.

Single-tablet regimen of emtricitabine/tenofovir disoproxil fumarate plus cobicistat-boosted elvitegravir increase adherence for HIV postexposure prophylaxis in sexual assault victims

2020 ◽  
pp. sextrans-2020-054714
Author(s):  
Stefano Malinverni ◽  
Floriane Bédoret ◽  
Magali Bartiaux ◽  
Christine Gilles ◽  
Stéphane De Wit ◽  
...  
Keyword(s):  
Sexual Assault ◽  
Tenofovir Disoproxil Fumarate ◽  
Public Health Intervention ◽  
Clinic Visit ◽  
Postexposure Prophylaxis ◽  
Retrospective Case ◽  
Patient Demographics ◽  
Single Tablet Regimen ◽  
Assault Victims

BackgroundPostexposure prophylaxis (PEP) is a recommended public health intervention after a sexual assault to prevent HIV infection.MethodsWe conducted a retrospective case-control study on how use of a single-tablet regimen (STR) of elvitegravir/cobicistat/emtricitabine/tenofovir disoproxil fumarate (Stribild) affected adherence to PEP and attendance of a follow-up visit to the STI clinic compared with those who received a multitablet regimen (MTR). Data from sexual assault victims consulting for PEP were prospectively recorded between January 2011 and December 2017. Data were systematically collected on patient demographics, time of medical contact, source risk factors, type of exposure, attendance to follow-up visit, reported completion of PEP and adherence based on pharmacy records.ResultsA total of 422 patients received PEP following a sexual assault, of whom 52% had documented completion of a 28-day PEP regimen and 71% attended a follow-up clinic visit. Patients who received an elvitegravir/cobicistat/emtricitabine/tenofovir disoproxil fumarate (EVG/COBI/FTC/TDF)-based STR had a similar likelihood of attending their first follow-up visit (OR: 0.97; 95% CI: 0.64 to 1.48, p=0.90) but were more likely to complete the PEP regimen (OR: 1.70; 95% CI: 1.16 to 2.50, p=0.007). After adjusting for confounders, those who were prescribed an STR regimen were more likely to complete the PEP regimen (OR: 1.66, 95% CI: 1.09 to 2.53, p=0.019) than those who were prescribed an MTR such as stavudine/lamivudine/lopinavir/ritonavir or zidovudine/lamivudine/indinavir/ritonavir.ConclusionsSexual assault victims who were prescribed an STR based on EVG/COBI/FTC/TDF were more likely to complete PEP than those who were prescribed an MTR.

Current Practice of HIV Postexposure Prophylaxis Treatment for Sexual Assault Patients in an Emergency Department

2014 ◽  
Vol 24 (4) ◽  
pp. e407-e412 ◽  
Author(s):  
Kathleen H. Krause ◽  
Annie Lewis-O'Connor ◽  
Amanda Berger ◽  
Teress Votto ◽  
Sigal Yawetz ◽  
...  
Keyword(s):  
Emergency Department ◽  
Sexual Assault ◽  
Current Practice ◽  
Postexposure Prophylaxis

scholarly journals HIV Postexposure Prophylaxis Use Among Ontario Female Adolescent Sexual Assault Victims: A Prospective Analysis

2008 ◽  
Vol 35 (12) ◽  
pp. 973-978 ◽  
Author(s):  
Janice Du Mont ◽  
Terri L. Myhr ◽  
Heather Husson ◽  
Sheila Macdonald ◽  
Anita Rachlis ◽  
...  
Keyword(s):  
Sexual Assault ◽  
Female Adolescent ◽  
Prospective Analysis ◽  
Postexposure Prophylaxis ◽  
Assault Victims

scholarly journals PIN78 CHARACTERIZATION OF UNNECESSARY EMERGENCY DEPARTMENT ENCOUNTERS FOR RABIES POSTEXPOSURE PROPHYLAXIS VACCINATION

2020 ◽  
Vol 23 ◽  
pp. S181
Author(s):  
T. Iso ◽  
A.T. Tran ◽  
F. Yuan ◽  
E. Rizk ◽  
D. Espino ◽  
...  
Keyword(s):  
Emergency Department ◽  
Postexposure Prophylaxis
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