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Show HIV PrEP Referral Protocol Implementation: A Quality Improvement Project Mikayla Stokes, BSN, RN; Katherine Heller, DNP, APRN, FNP; Melinda Patterson, DNP, MSN, RN, NE-BC Key Take Away . HIV PrEP provider education and referral protocol implementation improves Women’s Health APRNs' knowledge, comfort level, patient counseling, and referral for HIV preventive healthcare services Background • • • HIV PrEP is highly effective at preventing HIV transmission and contraction in at-risk patient populations The U.S. had ~32,000 new HIV infections in 2022; the CDC aims to reduce this to 3,000 by 2030 with resources such as PrEP A barrier to women receiving HIV PrEP therapy is a lack of provider knowledge and experience in utilizing PrEP Purpose Create and implement a provider education presentation and referral protocol to increase the rate of HIV prevention counseling and referrals for HIV PrEP in a Women 's Health APRN practice associated with a large academic healthcare system in Salt Lake City, UT Methods Assessed provider's baseline processes/ practices of screening for HIV contraction risk and referral for preventive services Developed an evidence-based HIV PrEP referral protocol based on CDC guidelines Implemented evidence-based HIV PrEP referral protocol Evaluated: PDSA cycle during the implementation period • Use of referral protocol and missed opportunities for 12 weeks, implementing rapid cycle changes via SWOT analyses Pre and post-survey: • Changes to provider screening and counseling practices • Feasibility, usability, and satisfaction with referral protocol Chart review: number of referrals placed pre/ post implementation Results • Improved provider confidence in the indicated use, safety, and efficacy of HIV PrEP from pre- to postimplementation • 89% (n=8) of providers pre-implementation “never” counseled patients on HIV PrEP, whereas postimplementation, 54% (n=7) had begun to counsel “a few” patients • 100% (n=5) of the providers who utilized the HIV PrEP referral protocol were “satisfied,” and 80% (n=4) were “likely” or “very likely” to use it in the future on Likert-scaled questions • Post-implementation, 85% (n=11) of providers stated “agree” or “somewhat agree” that HIV PrEP counseling services should be offered in the practice setting Conclusions • Post implementation, providers felt improved confidence to risk stratify, counsel and refer for HIV PrEP • 2 potential referrals were placed for HIV PrEP • Long-term adoption of referral protocol into clinical practice is presumed to improve rates of HIV PrEP utilization by Women’s Health APRN patient population • Future projects may involve implementing a protocol for BCHC providers to offer PrEP, along with other prophylactic therapies such as doxy PEP @uofunursing @utnurseresearch |
