Six Moments of Infection Prevention in Injection Drug Use: An Educational Toolkit for Clinicians

Author:

Harvey Leah12ORCID,Boudreau Jacqueline34,Sliwinski Samantha K34,Strymish Judith5,Gifford Allen L234,Hyde Justeen34,Linsenmeyer Katherine15,Branch-Elliman Westyn3456

Affiliation:

1. Department of Medicine, Section of Infectious Diseases, Boston University School of Medicine and Boston Medical Center, Boston, Massachusetts, USA

2. Department of Medicine, Section of General Internal Medicine, Boston University School of Medicine and Boston Medical Center, Boston, Massachusetts, USA

3. Center for Healthcare Organization and Implementation Research, Boston, Massachusetts, USA

4. Center for Healthcare Organization and Implementation Research, Bedford, Massachusetts, USA

5. Department of Medicine, Veterans Affairs Boston Healthcare System, Boston, Massachusetts, USA

6. Harvard Medical School, Boston, Massachusetts, USA

Abstract

Abstract Background Injection drug use–associated bacterial and viral infections are increasing. Expanding access to harm reduction services, such as safe injection education, are effective prevention strategies. However, these strategies have had limited uptake. New tools are needed to improve provider capacity to facilitate dissemination of these evidence-based interventions. Methods The “Six Moments of Infection Prevention in Injection Drug Use” provider educational tool was developed using a global, rather than pathogen-specific, infection prevention framework, highlighting the prevention of invasive bacterial and fungal infections in additional to viral pathogens. The tool’s effectiveness was tested using a short, paired pre/post survey that assessed provider knowledge and attitudes about harm reduction. Results Seventy-five respondents completed the paired surveys. At baseline, 17 respondents (22.6%) indicated that they had received no prior training in harm reduction and 28 (37.3%) reported discomfort counseling people who inject drugs (PWID). Sixty respondents (80.0%) reported they had never referred a patient to a syringe service program (SSP); of those, 73.3% cited lack of knowledge regarding locations of SSPs and 40.0% reported not knowing where to access information regarding SSPs. After the training, 66 (88.0%) reported that they felt more comfortable educating PWID (P < .0001), 65 respondents (86.6%) reported they planned to use the Six Moments model in their own practice, and 100% said they would consider referring patients to an SSP in the future. Conclusions The Six Moments model emphasizes the importance of a global approach to infection prevention and harm reduction. This educational intervention can be used as part of a bundle of implementation strategies to reduce morbidity and mortality in PWID.

Funder

Veterans Affairs Health Services Research and Development Innovations

National Heart, Lung, and Blood Institute

Boston University Clinical HIV/AIDS Research Training program

Publisher

Oxford University Press (OUP)

Subject

Infectious Diseases,Oncology

Reference36 articles.

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3. Notes from the field: HIV infection investigation in a rural area—West Virginia, 2017.;Evans;MMWR Morb Mortal Wkly Rep,2018

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