The assignment will be used to develop a written implementation plan.

Instructor:

Medication adherence is a key concept in nursing practice and impacts the care of patients throughout the healthcare system. The population for the evidence-based practice (EBP) change project will be African American adults with positive HIV status. Adult African American’s with HIV infection suffer from a decreased quality of life along with multiple hospitalizations and readmissions related to HIV medication non-adherence. Nurses have the ability to improve clinical outcomes for patients by providing quality education. Studies revealed that patients knowledgeable in the area of medication adherence. Literature revealed that education could address the knowledge gab regarding medication adherence (Wagner, et al., 2016). The purpose of this EBP change project will be to increase knowledge associated with HIV medication adherence through the use of an education program followed by telephone follow up, which will increase adherence to using HIV medications. The desired outcomes will be; a) An increased knowledge associated with HIV medication adherence; and b) Increased adherence to using HIV medication, which will ultimately improve patient outcomes.

The use of evidence-based practice (EBP) in a clinical setting positively boosts patient outcomes, and quality of care (Melnyk & Fineout-Overholt, 2011). A literature search supported the development of an educational intervention to increase medication adherence for positive human immunodeficiency virus (HIV) African American adults. In order to affirm accomplishment, a well drafted program and strategy with a clear vision on how to implement the change must be in place (Melnyk & Fineout-Overholt, 2011). According to epidemiologists at the Centers for Disease Control and Prevention (CDC; 2014), blacks/African Americans have the highest number of HIV infections compared with other races and ethnicities. Adult African American’s are disproportionately affected by the HIV infection (CDC, 2014).

Blacks make up approximately 12% of the U.S. population, but had approximately 44% of new HIV infections in 2010. Blacks/African Americans also encompass 41% of people living with HIV infection in 2011 (CDC, 2014). There was a common misconception that medication adherence was the sole responsibility of the patient; however, medication adherence has multiple contributing and causative factors. Adherence was a multidimensional phenomenon determined by the interaction of five sets of factors: social/economic factors; therapy-related factors; patient-related factors; condition-related factors; and health system/ health care team-related factors (Kalogianni, 2011).

Even as remarkable advances in drug treatment and outcomes has been made in recent years, the HIV disease continues and while patients are living longer, they must continue to have high quality care. It was essential for patients receiving treatments for HIV to maintain consistent high levels of adherence to their prescribed treatment regimen to optimally benefit (Iacob, Iacob, & Jugulete, 2017). If adherence is either intermittent or consistently below 95% of doses taken as prescribed, resistance to the current medication may develop and the regimen will fail, that is, the patient will not achieve an undetectable HIV VL (Edwards, 2006). Furthermore, the patient’s future therapeutic options may also be compromised once resistance develops because of cross-resistance between HIV medications. The EBP change will be accomplished by implementing and asking clinical questions using the PICO format. The acronym for PICO stands for: P is for patient population; I is Intervention; C is for Comparison; and O is for Outcome. The PICO question guiding this topic inquiry will be: “For HIV positive African American adults, does an educational program regarding medication adherence lead to increased knowledge through the use of an education program followed by telephone follow, which will ultimately increase adherence to using HIV medications”.

References

Center for Disease Control and Prevention. (2014). HIV in the United States: At a glance.