NURS FPX 6011 Assessment 3 Implementing Evidence-Based Practice

Name

Capella university

NURS-FPX 6011 Evidence-Based Practice for Patient-Centered Care and Population Health

Prof. Name

Date

Implementing Evidence-Based Practice

The introduction of technology-based patient engagement strategies in Human Immunodeficiency Virus (HIV) management represents a pivotal shift towards optimizing care delivery and improving patient outcomes in Acquired Immunodeficiency Syndrome (AIDS) (Orta et al., 2023). This evaluation assesses the value and relevance of evidence supporting this practice change. The following analysis explores the implications of this evidence on guiding practice change in HIV care, aligning with the Quadruple Aim framework to improve patient experience. 

PICOT Question

In adult patients living with HIV (P), does the implementation of technology-based patient engagement strategies (I) compared to standard care without such strategies (C) lead to improved medication adherence (O) within a three-month timeframe (T)?

Population: Adult patients living with HIV

Intervention: Technology-based patient engagement strategies

Comparison: standard care without such strategies

Outcome: Improved medication adherence 

Time: Three-month

Backgrounds

HIV remains a significant global health concern, impacting millions worldwide. Despite strides in treatment and prevention strategies, HIV remains a chronic condition requiring lifelong management. Current data suggests that approximately 38 million individuals globally live with the virus. In the United States, by the end of 2021, about 1.2 million people were living with HIV, with roughly 87% aware of their status. In 2021, an estimated 32,100 new HIV infections were reported in the U.S. (Armstrong et al., 2022).

Effective HIV care entails addressing various needs, including medication adherence, health literacy, and cultural considerations. Patient engagement is crucial in promoting adherence to Antiretroviral Therapy (ART) regimens, leading to viral suppression and improved health outcomes (De Clercq et al., 2020). Leveraging healthcare technology, such as mobile applications and telehealth services, offers innovative solutions to enhance patient engagement and bridge gaps in HIV care delivery, ultimately aiming to improve the quality of life for individuals living with HIV (Noorman et al., 2023).

Action Plan

Recommended Practice Change

The action plan will include several key components to implement the evidence-based practice project focused on improving patient engagement in HIV care through technology. First, recommendations for practice change will involve integrating technology-based patient engagement strategies into the existing healthcare system. This will include the development and implementation of smartphone applications for medication reminders (Orta et al., 2023).

Proposed Timeline for Implementation

Over three months, the project will conduct a needs assessment and develop technology solutions for HIV care. Staff training and pilot testing will occur in month one, followed by implementation and patient education in month two. In the final month, monitoring, evaluation, and adjustments will take place, with scaling up across all healthcare settings (Haynes et al., 2022). This systematic approach aims to improve patient engagement in HIV care through the effective use of technology, ensuring sustainable implementation and long-term benefits for both patients and healthcare providers (Conley et al., 2022).

Tools or Resources Needed to Support the Project

Tools and resources needed for successful implementation include access to technology infrastructure, such as smartphones and internet connectivity, as well as collaboration with IT experts for app development and support (Noorman et al., 2023). Additionally, staff training programs will be essential to ensure healthcare providers are proficient in utilizing the new technology and effectively engaging patients. Ongoing support and feedback mechanisms will be established to address any challenges and optimize the use of technology in HIV care delivery (Balakrishnan & Shankar, 2023).

Stakeholders and Potential Barriers

Stakeholders

Key stakeholders include healthcare providers, IT professionals for technology implementation, patients living with HIV, and administrative staff. Engaging stakeholders through regular communication and feedback sessions ensures alignment with project goals and fosters a sense of ownership (Noorman et al., 2023).

Innovation Opportunities

Opportunities include leveraging smartphone applications for medication reminders and telehealth services for remote consultations. Integration of artificial intelligence for personalized interventions presents innovative possibilities. Collaboration with community organizations can expand reach and address diverse patient needs (Landovitz et al., 2023).

Potential Barriers

Barriers can include resistance to change among staff, limited access to technology, and concerns about data privacy and security. Specific actions to overcome these barriers include comprehensive staff training and support, provision of technology resources to patients, and adherence to strict data protection protocols. Additionally, proactive communication and transparency regarding privacy measures can alleviate concerns and build trust (Landovitz et al., 2023). In addition to resistance to change, barriers in HIV care may stem from language and cultural differences.

Overcoming these barriers requires culturally sensitive training programs for staff to understand and respect diverse cultural practices and beliefs. Specific actions include integrating language interpretation services, providing culturally tailored educational materials, and fostering partnerships with community organizations. These efforts promote effective communication and trust-building with patients from diverse backgrounds, ultimately enhancing engagement and improving health outcomes in HIV care (Owusu et al., 2023).

Outcome Criteria

Outcome criteria for evaluating the evidence-based practice project should include measures related to medication adherence, health outcomes, patient satisfaction, and cost-effectiveness. Improved medication adherence can be assessed through objective measures such as viral load suppression and adherence rates to ART regimens. Health outcomes can be evaluated by monitoring indicators such as CD4 cell count, HIV-related complications, and overall quality of life assessments (Balakrishnan & Shankar, 2023). Patient satisfaction can be measured through surveys or feedback mechanisms to gauge perceptions of the effectiveness and usability of the implemented technology solutions. Additionally, a productive analysis should be led to evaluate the financial associations of the project, including any potential savings associated with improved health outcomes and reduced healthcare utilization (Conley et al., 2022).

The outcome measures will inform evidence-based practice by providing quantitative data on the effectiveness of technology-based patient engagement strategies in HIV care. Positive outcomes can contribute to the development of guidelines and policies promoting the integration of such interventions into standard HIV care protocols, ensuring that future practices are informed by evidence and aimed at optimizing patient outcomes (Li et al., 2024). Over three months, outcome measures for evaluating the evidence-based practice project in HIV care include medication adherence, health outcomes, patient satisfaction, cost-effectiveness, informing evidence-based practice, and potential guideline development.

Alignment with Quadruple Aim

These outcome measures will inform evidence-based practice by providing quantitative data on the effectiveness of technology-based patient engagement strategies in HIV care. Positive outcomes can contribute to the development of guidelines and policies promoting the integration of such interventions into standard HIV care protocols (Bacon et al., 2023). Moreover, aligning with the Quadruple Aim framework highlights the significance of these outcome criteria, which aim to enhance patient outcomes, experience, cost-effectiveness, and provider well-being. By demonstrating improvements in all four domains of the Quadruple Aim, the project can serve as a model for advancing evidence-based practice and guiding future healthcare policies in HIV management (Bacon et al., 2023).

Evaluation of Evidence

The evidence supporting the need for a practice change in HIV management through technology-based patient engagement strategies is robust and relevant. Systematic reviews of peer-reviewed journal articles retrieved from PubMed, Google Scholar, and Cochrane Library revealed consistent findings. Studies like Orta et al. (2023), Balakrishnan and Shankar (2023), and Bacon et al. (2023), consistently demonstrated that technology interventions, such as smartphone applications and telehealth services, improve medication adherence, viral suppression, and health outcomes in adults living with HIV (Cheong et al., 2023). These resources were specifically relevant to our HIV management context, providing insights tailored to the challenges and needs of our patient population

Findings

Key findings from the evidence include increased medication adherence rates among patients utilizing smartphone applications for medication reminders and educational resources. Telehealth services were associated with improved access to care, particularly among marginalized populations having HIV, facing barriers to traditional healthcare access. Additionally, technology-based interventions for HIV were shown to enhance patient-provider communication, leading to better treatment acceptance and adherence (Bacon et al., 2023). The search methodology targeted randomized controlled trials, meta-analyses, and systematic reviews published within the last five years to guarantee the correctness and credibility of the evidence (Cheong et al., 2023).

References

Armstrong, E. A., Tetteh, A. K., Ofori, E., & Ekhosuehi, O. (2022). Voluntary counseling and testing, antiretroviral therapy access, and HIV-related stigma: Global progress and challenges. International Journal of Environmental Research and Public Health, 19(11). https://doi.org/10.3390/ijerph19116597 

Bacon, A., Wang, W., Lee, H., Akin, D., Tan, A., Hirshfield, S., Demirci, U., Wang, X., & Cunningham, B. T. (2023). Review of HIV self testing technologies and promising approaches for the next generation. Biosensors, 13(2), 298–298. https://doi.org/10.3390/bios13020298 

Balakrishnan, P., & Shankar, E. M. (2023). Recent advances in HIV diagnostics: Point-of-care CD4+ T-cell count & viral load assays. PubMed, 158(6), 447–450. https://doi.org/10.4103/ijmr.ijmr_1616_23 

Cheong, H., Lyons, A., Houghton, R., & Majumdar, A. (2023). Secondary qualitative research methodology using online data within the context of social sciences. International Journal of Qualitative Methods, 22(1). https://doi.org/10.1177/16094069231180160 

Conley, C., Johnson, R., Bond, K., Brem, S., Salas, J., & Randolph, S. (2022). US Black cisgender women and pre-exposure prophylaxis for human immunodeficiency virus prevention: A scoping review. Women’s Health, 18. https://doi.org/10.1177/17455057221103098 

De Clercq, J., Rutsaert, S., De Scheerder, M.-A., Verhofstede, C., Callens, S., & Vandekerckhove, L. (2020). Benefits of antiretroviral therapy initiation during acute HIV infection. Acta Clinica Belgica, 77(1), 1–9. https://doi.org/10.1080/17843286.2020.1770413 

NURS FPX 6011 Assessment 3 Implementing Evidence-Based Practice

Haynes, B. F., Wiehe, K., Borrrow, P., Saunders, K. O., Korber, B., Wagh, K., McMichael, A. J., Kelsoe, G., Hahn, B. H., Alt, F., & Shaw, G. M. (2022). Strategies for HIV-1 vaccines that induce broadly neutralizing antibodies. Nature Reviews Immunology, 23. https://doi.org/10.1038/s41577-022-00753-w 

Landovitz, R. J., Scott, H. M., & Deeks, S. G. (2023). Prevention, treatment and cure of HIV infection. Nature Reviews Microbiology , 22. https://doi.org/10.1038/s41579-023-00914-1 

Li, K., Thaweesee, N., Kimmel, A., Dorward, E., & Dam, A. (2024). Barriers and facilitators to utilizing HIV prevention and treatment services among migrant youth globally: A scoping review. PLOS Global Public Health, 4(2). https://doi.org/10.1371/journal.pgph.0002851 

Metzner, K. J. (2022). Technologies for HIV-1 drug resistance testing: Inventory and needs. Current Opinion in HIV and AIDS, 17(4), 222–228. https://doi.org/10.1097/coh.0000000000000737 

Noorman, J., Marcos, T. A., Stutterheim, S. E., & Jonas, K. J. (2023). The importance of social engagement in the development of an HIV cure: A systematic review of stakeholder perspectives. AIDS and Behavior, 27(11), 3789–3812. https://doi.org/10.1007/s10461-023-04095-z 

Orta, G. A., Fletcher, J. B., Young, L. E., & Klausner, J. D. (2023). Virtual avatars as a new tool for human immunodeficiency virus prevention among men who have sex with men: A narrative review. MHealth, 9, 29–29. https://doi.org/10.21037/mhealth-22-33 

Owusu, M. W., Krankowska, D. C., Lourida, P., & Weis, N. (2023). Late HIV diagnosis among migrant women living in Europe- A systematic review of barriers to HIV testing. IJID Regions, 7, 206–215. https://doi.org/10.1016/j.ijregi.2023.03.006