Hospital zero hepatitis: Easy and useful!

Abstract

Background: 59000 hepatitis C virus (HCV) infected patients were unknown or not followed in France In 2017, 81% of our 'new' patients followed for fist time have already been hospitalized in our hospital, specially in emergency units Hepatitis C was noted in their file as other medical histories like appendicitis or shin fracture Drug users came one to twelve times per year in hospital for different reasons, but never for HCV care. No HCV specialized guidance was offered to them after the initial pathology was resolved Hospital could be a specific gateway to screening and care of HCV infection. The hospital could be a specific gateway to screening and care of HCV infection. Methods: Objective of our study was to identify HCV patients coming in our hospital by teaching and motivation nurses of every service for a goal of zero hepatitis hospital After information from the executive and management of each unit, our hepatitis specialized nurse from MHT did training sessions of nurses in every unit of our hospital about hepatitis C screening, diagnosis, follow up and treatment She insisted about importance of early diagnosis, none invasive evaluation of liver fibrosis and treatment by direct antiviral agents The main information was 'a diagnosed patient was a cured patient' She also taught how and when calling hepatitis nurse if they had HCV positive patient. Nurses of each unit informed HCV patients that hepatitis nurse came and obtained their consent. She gave specific flyers and posters to remember this project easier. Flyer of information and poster reminiscent of the hepatitis nurse's contact information was left in the care room Our study began on September 2017 Results: In 16 months, hepatitis nurse did training sessions in 16 units of our hospital, including 92 nurses: 9 medicine units, 6 surgery units and maternity ward Gastroenterology, visceral surgery, pneumology and neurosurgery were most frequent units They received 78 calls about 75 patients with hepatitis C; 71 patients were current or formers drug users, 32 patients are known as negative viral load, spontaneously or after antiviral treatment; 61% of patients had social rights difficulties; 43 had positive viral load and took care by our team with measure of liver fibrosis by Fibroscan; 33 started immediately DAA treatment No patient refused to see specialized hepatitis nurses All drug users had also risk reduction session, even they had negative viral load There was quickly progressive increase of phone calls as the project was rolled out Conclusion: Training of nursing relays within the different units of a hospital center is easy to set up and useful to orient in a specialized circuit HCV patients not previously supported, especially for drug users Same experience could be transferable to other hospital centers and creates dynamic zero-hepatitis hospital throughout the institution Next step will be to develop our project in all units of our hospital specially in emergency units.