Doctor of Nursing Practice (DNP) Projects
Access Control
Open Access
Degree Program
Doctor of Nursing Practice
Degree Track
Family Nurse Practioner
Year Degree Awarded
2023
DOI
https://doi.org/10.7275/35299235
Month Degree Awarded
May
Keywords
human immunodeficiency virus, acquired immune deficiency syndrome, homeless, antiretroviral therapy, directly observed therapy, substance use disorder
Advisor
Kalpana Poudel Tandukar and Jeungok Choi
DNP Project Chair
Kalpana Poudel Tandukar
Abstract
Background: Antiretroviral directly observed therapy, in which nurses or other allied health professionals provide patients with daily medication, is an evidence-based solution for viral load suppression in people living with HIV who experience homelessness. Purpose: This quality improvement project aimed to assess the outcomes of antiretroviral directly observed therapy at one urban clinic caring for people living with human immunodeficiency virus who experience homelessness and substance use disorder. Methods: Data was collected from the electronic health record for the antiretroviral directly observed therapy patient cohort (n = 33); 10 of them were surveyed. Fisher exact tests determined nonrandom associations between viral suppression and all other categorical variables. Survey answers were mapped to the modified Andersen’s Behavioral Model domains and subcategories. Results: Seventy-three percent of program patients were virally suppressed after participating in the program; 42% were virally undetectable. The relationship between viral suppression and date of most recent primary care provider visit was significant (p = 0.01). Eighty percent of surveyed patient participants reported that they liked the program, and 70% said that taking ART makes them feel better. Eighty percent of patients described their health as “Fair” or “Poor” before initiating treatment with the program, while 90% of patients reported their own health as being “good”, “very good”, or “excellent” after participating. Conclusion: Results suggest that when nurse-led teams actively engage PLWH, viral suppression, and consequent undetectability, is more likely. Clear implications for practice include continuing nurse navigation to promote viral suppression.
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This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 3.0 License.
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Behavioral Medicine Commons, Community Health Commons, Family Medicine Commons, Family Practice Nursing Commons, Immune System Diseases Commons, Infectious Disease Commons, Medical Immunology Commons, Other Mental and Social Health Commons, Preventive Medicine Commons, Primary Care Commons, Psychiatric and Mental Health Commons, Quality Improvement Commons, Substance Abuse and Addiction Commons, Virus Diseases Commons