RESUMEN
BACKGROUND: Health Education in the emergency department (ED) is one of the tasks that the HIV-exposure triage implementation needs to be considered. No triage training has been evaluated. METHODS: A prospective 3-years pre- and post-intervention study in an urban academic ED was realized. The intervention was a simulation-based training on triage rules for triage nurses. Triage is based on time between HIV-exposure and ED arrival (≤48â¯h: level 2 (urgent); ≥48â¯h: level 5 (non-urgent)). FINDINGS: A total of 2011 HIV-exposures were included; 15.1 per cent were well triaged in pre-intervention vs. 88 per cent in post-intervention period (Pâ¯<â¯0.0001). Among well-triaged patients as level 2, the post-exposure prophylaxis prescription rate increased from 30.5 to 57.6 per cent (Pâ¯<â¯0.0001). Time interval quality indicators (minutes) were: ED arrival-Triage Nurse 10.9⯱â¯9.6 vs. 9.1⯱â¯4.8 (Pâ¯<â¯0.0001), ED arrival-Physician 56.3⯱â¯26.0 vs. 49.9⯱â¯36.0 (Pâ¯=â¯0.0001), and ED arrival to Post-exposure prophylaxis first-dose 86.9⯱â¯30.0 vs. 65.2⯱â¯42.0 (Pâ¯<â¯0.0001). CONCLUSIONS: These results suggest that time interval HIV-exposure to ED arrival can be used as a triage criterion. A continuous quality improvement program for PEP after HIV-exposure based on a nurse triage training program achieved the objectives of optimizing the triage performance by reducing the time to access the post-exposure prophylaxis first-dose.