Preexposure prophylaxis for HIV prevention: A highlight of the updated clinical practice guideline.

ABSTRACT: The prevention of HIV is continually evolving with the development of new resources and the adaptation of older resources in new regimens. Ideally, these new and updated methods of prevention will allow easier implementation and continuation as well as reduced costs in the fight to prevent HIV infections.

Capacity building in nurse educators in a Global Leadership Mentoring Community.

Globally, nurse educators participate in the three main role activities of teaching, scholarship, and service. Matching for different global locations and career stages, 12 mentor-mentee pairs completed a one-year coordinated virtual program through Sigma Theta Tau International's Global Leadership Mentoring Community and mentees reported building their nurse educator capacities. The authors describe factors that potentially influence international mentoring such as language, time, technology, and key characteristics of mentoring relationships. Growth in educator roles occurred in the contexts of the culture of academe itself and Boyer's definitions of scholarship. Consistent with Sigma's vision statement, nurse educators have a global presence and responsibility to prepare competent nurses who can advance the health of the world's people. Readers may benefit for future planning of mentoring activities to build capacities in nurse educator roles through international interactions.

Initiating pre-exposure prophylaxis: What primary care providers should know.

ABSTRACT: Pre-exposure prophylaxis (PrEP) is an HIV preventive service and treatment that is continuing to evolve. With the availability of in-house lab screenings and simplified testing protocols, primary care providers are in a unique position to initiate and provide the added layer of HIV protection for their patients.

Outcomes From an Urgent Care Pre-exposure Prophylaxis Protocol for the Prevention of HIV.

Pre-exposure prophylaxis (PrEP) and urgent care medical providers can be powerful allies when combined in the fight against HIV infection. Unfortunately, PrEP use in the urgent care setting is underused due to a lack of resources, provider staff knowledge, and comfort on the part of providers. An urgent care-specific PrEP protocol was developed, and 29 providers from six different urgent care facilities in Louisiana participated in a 20-week quality improvement project. The developed urgent care-specific PrEP protocol resulted in an increase in knowledge and comfort and a reduction in barriers associated with PrEP use. Overall, the urgent care PrEP protocol showed the ability to assist the urgent care clinician in many areas previously noted in research as reasons for reduced PrEP use. The urgent care PrEP protocol serves as an additional tool for the urgent care providers in HIV biomedical preventative care. The results of this project are reported using the Standards of Quality Improvement Reporting Excellence.

Addressing transgender patients' barriers to access care.

The transgender population faces several barriers to accessing quality medical care in the US healthcare system. This article examines the challenges that prevent this marginalized group from obtaining high-quality healthcare services and discusses how NP advocacy can help create a welcoming environment for transgender patients.

HIV Health Care Transition Readiness: Embracing the Opportunity and Challenge.

Because of effective treatment and prolonged survival, thousands of young adult people living with HIV will need to transfer their health care to adult care providers. However, many lack basic essential skills and are not prepared for this transition. Many providers do not assess transition readiness on a regular basis. Validated transition readiness assessment tools can help providers guide interventions based on identified skill and knowledge deficits. Our purpose was to describe the impact of incorporating a validated Transition Readiness Assessment Questionnaire (TRAQ) into clinical practice. A retrospective chart review of 48 patients with HIV, ages 22-24 years, showed that the use of the TRAQ significantly affected provider interventions in the area of medication management (odds ratio: 0.02). Overall, the use of the TRAQ did not increase clinical interventions; however, it enabled providers to identify knowledge or skill deficits not previously addressed and to plan future clinical interventions to meet individual patient needs.

The Effect of Transplant Education on Nurses Attitudes Toward Organ Donation and Advocacy for Transplantation.

Nurses are the largest group of health-care professionals, yet they are not uniformly educated regarding transplantation and organ donation. The future of transplantation hinges on education of this group. Before meaningful studies can be conducted, an instrument to measure attitudes and commitment to organ transplantation is needed. The purpose of this study was to examine content and construct validity as well as establish internal reliability of an investigator-developed online instrument to measure nurses' attitudes and commitment to organ transplantation by registered nurses. The online instrument was administered to registered nurses enrolled in transplantation electives at the University of Alabama in Huntsville and Vanderbilt University. Exploratory factor analysis revealed 4 components with eigenvalues over 1.0. The components were as follows: (1) desire to work in transplantation, (2) confidence in transplantation advocacy, (3) organ donation advocacy, and (4) procurement. Internal consistency of the revised instrument was established (α = .94). The Transplant-Registered Nurse (TXP-RN) instrument is a new instrument with excellent reliability and validity that can be used to measure attitudes and knowledge of American nurses about organ donation and transplantation. This important step is necessary before educational interventions can be accurately assessed.

Providers' Attitudes and Knowledge of Lesbian, Gay, Bisexual, and Transgender Health.

A survey of community-based outpatient clinic health care providers suggests the need for additional education and training to increase their cultural competencies.

Leadership Initiatives in Patient-Centered Transgender Care.

Advanced practice nurses develop solutions that can improve health care access and services for transgender persons in the VA.

The Health Promotion Model in HIV Care / El modelo de promoción de la salud en el cuidado del VIH / O modelo de promoção da saúde no cuidado do HIV

ABSTRACT Effective medical treatment with uninterrupted engagement in care is critical to improving the survival and the quality of life of patients infected with the human immunodeficiency virus (HIV). Objectives: Multiple behavioral interventions have been conducted to promote adherence behaviors. However, adherence to HIV medications and medical appointments is still an issue of global concern. Method: The Health Promotion Model (HPM) is a nursing adaption of the health belief model. The HPM focuses on individual characteristics and experiences, as well as behavior specific cognitions and outcomes. Integrating the HPM in addressing adherence behaviors could be one of the building blocks of success in changing health behavior. Results: A search of the literature turned up no studies that applied the HPM in adherence behavior studies conducted among HIV-infected populations. Conclusion: This paper presents the reader with the availability of current adherence-behavior interventions and strategies that align with the HPM model components. It further proposes the need for medical treatment team members to adopt the HPM in current clinical practice settings so as to effectively address adherence behavior issues.

RESUMEN Un tratamiento médico eficaz con un compromiso ininterrumpido en el cuidado es crítico para mejorar la supervivencia y la calidad de vida de los pacientes infectados con el virus de la inmunodeficiencia humana (VIH). Objetivos: se han llevado a cabo múltiples intervenciones conductuales para promover comportamientos de adherencia. Sin embargo, la adhesión a los medicamentos contra el VIH y las citas médicas siguen siendo un tema de preocupación mundial. Método: el modelo de promoción de la salud (HPM) es una adaptación de enfermería del modelo de creencias de salud. El HPM se centra en características y experiencias individuales, así como cogniciones y resultados específicos del comportamiento. La integración del HPM en el abordaje de los comportamientos de adherencia podría ser uno de los pilares del éxito en el cambio del comportamiento de la salud. Resultados: una búsqueda en la literatura no mostró ningún estudio que aplicó el HPM en los estudios de comportamiento de adherencia realizados entre las poblaciones infectadas por el VIH. Conclusión: este artículo presenta al lector la disponibilidad de las actuales intervenciones de adherencia-comportamiento y estrategias que se alinean con los componentes del modelo HPM. Además, propone la necesidad de que los miembros del equipo de tratamiento médico adopten el HPM en la práctica clínica actual con el fin de abordar eficazmente los problemas de comportamiento de adherencia.

RESUMO Um tratamento médico eficaz com um compromisso ininterrupto no cuidado é fundamental para melhorar a sobrevivência e a qualidade de vida dos pacientes infectados com o vírus da imunodeficiência humana (HIV). Objetivos: realizaram-se múltiplas intervenções comportamentais para promover condutas de adesão. No entanto, a adesão aos medicamentos contra o HIV e às consultas médicas continua sendo um tema de preocupação mundial. Método: o Modelo de Promoção da Saúde (HPM, por sua sigla em inglês) é uma adaptação de enfermagem do modelo de crenças em saúde. O HPM centra-se em características e experiências individuais, bem como cognições e resultados específicos do comportamento. A integração do HPM na abordagem dos comportamentos de adesão poderia ser um dos pilares do sucesso na mudança do comportamento da saúde. Resultados: uma busca na literatura não mostrou nenhum estudo que aplicou o HPM nos estudos de comportamento de adesão realizados entre as populações infectadas pelo HIV. Conclusão: este artigo apresenta ao leitor a disponibilidade das atuais intervenções de adesão-comportamento e estratégias que se alinham com os componentes do modelo HPM. Além disso, propõe a necessidade de que os membros da equipe de tratamento médico adotem o HPM na prática clínica atual ao fim fim de abordar eficazmente os problemas de comportamento de adesão.