capstone

For your final capstone project submission you will synthesize the work you completed in the previous five assessments. The only brand-new content that you will need to create for this assessment is an Abstract and an Introduction. Abstract

● Summarize the purpose, approach, and any relevant findings of the final capstone project submission

Introduction

● Summarize your need, target population, and setting ● Provide a high-level overview of your intervention plan ● Justify the importance of your need and intervention plan ● Provide a high-level overview of your implementation plan ● Provide a high-level over view of your evaluation plan 1. Lead organizational change to improve the experience of care, population

health, and professional work life while decreasing cost of care. 2. Evaluate the best available evidence for use in clinical and organizational

decision making. 3. Apply quality improvement methods to impact patient, population, and

systems outcomes. 4. Design patient- and population-centered care to improve health outcomes. 5. Integrate interprofessional care to improve safety and quality and to decrease

cost of care. 6. Evaluate the ability of existing and emerging information, communication, and

health care technologies to improve safety and quality and to decrease cost of care.

7. Defend health policy that improves the experience of care, population health, and professional work life while decreasing cost of care.

ADDITIONAL REQUIREMENTS

● Length of submission: 10 pages ● Written communication: Written communication is free of errors that detract

from the overall message.

● Number of resources: Minimum of 5 resources. ● APA formatting: Resources and citations are formatted according to current

APA style. ● Font and font size: Times New Roman, 12 point. ● Use 1” margins and in text citations

Rubric Capstone Research Paper

Criteria Ratings Pt s

This criterion is linked to a Learning Outcome

Statement of PICOT Question (Population; Intervention; Comparison Group; Outcome; Time Frame)

5 ptsFull MarksCorrect format followed: Each element addressed with detail and correctly identified

3 ptsHalf MarksCorrect format followed but information not correctly identified

0 ptsNo MarksCorrect format not followed: PICOT elements not clearly identified

5 pt s

This criterion is linked to a Learning Outcome

Location of External Evidence using appropriate resources (South Florida College of Nursing databases)

5 ptsFull MarksEvidence using appropriate resources (South Florida College of Nursing Database) Able to locate five research articles or equivalent relevant to PICOT question independently

3 ptsHalf MarksAble to locate five applicable research articles or equivalent but needed extensive assistance from professor

0 ptsNo MarksDid not locate two applicable research articles or equivalent even with maximum assistance

5 pt s

This criterion is linked to a Learning Outcome

Proposes existing or new policy considerations that would support the implementation of an intervention plan. Reflects on the ways in which the completed intervention, implementation, and evaluation plans can be transferred into one's personal practice to drive quality improvement in other contexts.

5 ptsFull MarksStudent proposes existing or new policy considerations that would support the implementation of an intervention plan. Reflects on the ways in which the completed intervention, implementation, and evaluation plans can be transferred into one's personal practice to drive quality improvement in other contexts.

3 ptsHalf MarksStudent partially proposes existing or new policy considerations that would support the implementation of an intervention plan. Reflects on the ways in which the completed intervention, implementation, but is lacking evaluation plans that can be transferred into one's personal practice to drive quality improvement in other contexts.

0 ptsNo MarksStudent does not proposes existing or new policy considerations that would support the implementation of an intervention plan. Student does not reflect on the ways in which the completed intervention, implementation, and evaluation plans can be transferred into one's personal practice to drive quality improvement in other contexts.

5 pt s

This criterion is linked to a Learning Outcome

Analyze current evidence to validate an identified need and its appropriateness within the target population and setting. Analyzes stakeholders, regulatory

5 ptsFull MarksStudent fully analyzes current evidence to validate an identified need and its appropriateness within the target population and setting. Analyzes stakeholders, regulatory implications, and potential support that could impact the implementation of an intervention plan.

3 ptsHalf MarksStudent partially analyzes current evidence to validate an identified need and its appropriateness within the target population and setting. Student partially analyzes stakeholders, regulatory implications, and potential support that could impact the implementation of an intervention plan.

0 ptsNo MarksStudent does not analyze current evidence to validate an identified need and its appropriateness within the target population and setting. Student does not analyze stakeholders, regulatory implications, and potential support that could impact the implementation of an intervention plan.

5 pt s

implications, and potential support that could impact the implementation of an intervention plan.

This criterion is linked to a Learning Outcome

Apply quality improvement methods to impact patient, population, and systems outcomes. Integrates resources from diverse sources that illustrate support for all aspects of an implementation plan for a planned intervention.

5 ptsFull MarksStudent fully applies quality improvement methods to impact patient, population, and systems outcomes. Integrates resources from diverse sources that illustrate support for all aspects of an implementation plan for a planned intervention.

3 ptsHalf MarksStudent partially applies quality improvement methods to impact patient, population, and systems outcomes. Integrates resources from diverse sources that illustrate support for all aspects of an implementation plan for a planned intervention.

0 ptsNo MarksStudent does not apply quality improvement methods to impact patient, population, and systems outcomes. Integrates resources from diverse sources that illustrate support for all aspects of an implementation plan for a planned intervention.

5 pt s

This criterion is linked to a Learning Outcome

Evaluate the ability of existing and emerging information, communication, and health care technologies to

5 ptsFull MarksStudent fully evaluates the ability of existing and emerging information, communication, and health care technologies to improve safety and quality and to decrease cost.

3 ptsHalf MarksStudent partially evaluates the ability of existing and emerging information, communication, and health care technologies to improve safety and quality and to decrease cost.

0 ptsNo MarksStudent does not evaluate the ability of existing and emerging information, communication, and health care technologies to improve safety and quality and to decrease cost.

5 pt s

improve safety and quality and to decrease cost.

This criterion is linked to a Learning Outcome

Grammar/Spelling/ Punctuation

5 ptsFull MarksCorrect spelling, punctuation, capitalization. Use of the standard English which demonstrates good grammar.

3 ptsHalf MarksSeveral mechanical errors that border on interfering with communication of ideas.

0 ptsNo MarksErrors in mechanics seriously interfere with communication. Writing inappropriate for audience.

5 pt s

This criterion is linked to a Learning Outcome

APA Formatting

5 ptsFull MarksAPA usage is accurate and used consistently throughout the paper.

3 ptsHalf MarksAPA errors border on interfering with communication of ideas.

0 ptsNo MarksNumerous APA errors which interfere with communication. Incorrect APA citation.

5 pt s

This criterion is linked to a Learning Outcome

Resources

5 ptsFull MarksStudent exceeded expectation and provided 5 resources or more along with current resources being within the last 5 years.

3 ptsHalf MarksStudent only provided 3 resource or provided resources older than 5 years.

0 ptsNo MarksStudent provided no resources or all resources where older than 5 years.

5 pt s

This criterion is linked to a Learning Outcome

Length of Paper

5 ptsFull MarksStudent wrote 8-10 pages, or exceeded the amount of pages requested.

3 ptsHalf MarksStudent wrote 6-7 pages, not the requested amount.

0 ptsNo MarksStudent wrote less than 4 pages.

5 pt s

Total Points: 50

DR.ELLEN RM THIS ARE THE PREVIOUS WORK BELOW OUTCOME

Capstone Evaluation Plan: Long-Acting Injectable Cabenuva for HIV Management

This evaluation plan is designed to determine the effects of long-acting injectable Cabenuva on

the management of HIV in virally suppressed adults in a period of six months. It establishes

objective results and uses a mixed-methods approach to assess the adherence, viral suppression,

patient satisfaction, and healthcare utilization, which guarantees strong, evidence-based results.

Outcome Goals

The intervention leverages Cabenuva to optimize HIV care. The primary outcome goals are:

1. Better Medication Adherence: The increase in adherence rate, which is the

number of monthly injection appointments, by at least 20 percent relative to the baseline

rate of oral antiretroviral therapy (ART) adherence, will ensure that treatment is

consistent.

2. Sustained Viral Suppression: Achieve viral suppression (viral load <200

copies/mL) in 90 percent of participants at six months, relative to historical oral ART

data, to delay disease progression.

3. Improved Patient Satisfaction: Achieve a 15 percent increase in validated survey

satisfaction scores, indicating greater convenience and ease of treatment and less stigma,

leading to long-term patient engagement.

4. Lower Healthcare Utilization: Reduce HIV-related emergency care or

hospitalization by 10 percent to enhance affordable care and quality.

These outcomes advance health promotion, care quality, and resource efficiency for a vulnerable

population.

Evaluation Plan

Data Collection Methods

The evaluation is based on a mixed-methods approach to evaluate the impact of the intervention.

Quantitative ones involve monitoring the monthly attendance of injection appointments through

electronic health records (EHRs), which will be compared to the baseline oral ART adherence

(percentage of doses taken) (Slama et al., 2023). The viral load is measured at baseline, month 3,

and month 6 using lab reports and compared with the data of oral ART clinics. EHRs track the

number of emergency visits and hospitalizations related to HIV when compared to past records

of oral ART. Patient satisfaction is measured using the Patient Satisfaction Questionnaire Short

Form (PSQ-18) at baseline and month 6 (Marshall & Hays, 1994).

Qualitative measures involve semi-structured interviews with 12 participants at month 6 to

explore treatment benefits, barriers, and stigma perceptions. Nurse focus groups at month 6

gather feedback on implementation challenges, such as training or workflow, and patient

engagement, providing nuanced insights into operational feasibility.

Evaluation Tools

The EHR system ensures secure, HIPAA-compliant tracking of adherence, viral load, and

utilization data, facilitating real-time monitoring. The PSQ-18, a validated instrument,

standardizes satisfaction assessment across care domains (Marshall & Hays, 1994). Interview

guides, developed with nursing and psychology expertise, align with cultural considerations and

intervention objectives to ensure relevant and sensitive data collection.

Timeline

Evaluation activities are structured over six months. In month 1, baseline data (adherence, viral

load, satisfaction) are collected, and staff are trained on protocols to ensure consistency. Months

2–5 involve monthly monitoring of adherence, viral load, and utilization. In month 6, final viral

load tests, PSQ-18 surveys, patient interviews, and nurse focus groups are conducted, followed

by data analysis. Post-month 6, findings are disseminated to stakeholders to inform future scaling

and policy decisions.

Stakeholder Responsibilities

Stakeholders play critical roles in the evaluation. Patients provide survey and interview data to

shape outcomes. Nurses collect clinical metrics and offer implementation feedback.

Administrators oversee EHR data extraction and resource allocation. Payers evaluate

cost-effectiveness to guide coverage decisions, ensuring the intervention’s sustainability.

Analysis

Quantitative data are analyzed using SPSS, with t-tests (p < 0.05) to compare outcomes between

Cabenuva and oral ART groups. Qualitative data undergo thematic analysis to identify themes,

such as stigma reduction, triangulated with quantitative results for validity. Outcomes are

benchmarked against HRSA standards to contextualize success (U.S. Department of Health and

Human Services, 2025). Bias is mitigated by blinding analysts to patient identities and using

multiple coders for qualitative reliability.

References

Marshall, G. N., & Hays, R. D. (1994). The Patient Satisfaction Questionnaire Short

Form (PSQ-18). RAND Corporation.

Slama, L., Porcher, R., Linard, F., Chakvetadze, C., Cros, A., Carillon, S., ... & Molina, J.

M. (2023). Injectable long acting antiretroviral for HIV treatment and prevention:

perspectives of potential users. BMC Infectious Diseases, 23(1), 98.

https://doi.org/10.1186/s12879-023-08071-9

U.S. Department of Health and Human Services. (2025). Health Resources and Services

Administration: HIV/AIDS Bureau. https://hab.hrsa.gov/

REFLECTION

Advocacy, Future Steps, and Reflection on Implementing Long-Acting Injectable

Cabenuva for HIV Management

The adoption of long-acting injectable Cabenuva (cabotegravir/rilpivirine) marks a

transformative approach to managing HIV in virally suppressed adults, addressing adherence

challenges inherent in daily oral regimens. This paper explores nurses' advocacy and leadership

in this change, its effects on practice and collaboration, future enhancements, and personal

reflections on leading improvements. By integrating evidence from clinical studies and policy

resources, it highlights the intervention's role in enhancing care quality for vulnerable

populations in clinical settings.

Advocacy

Nurses are at the center of leading the change in improving the quality and experience of care,

especially in the implementation of new treatment options such as Cabenuva in HIV

management. Nurses are frontline providers, which makes them particularly well-positioned to

recognize the gaps in the traditional oral antiretroviral therapy (ART), including adherence

obstacles, stigma, and logistical issues (Slama et al., 2023). In this capstone project, nurses will

be in the forefront in changing the frequency of injections to monthly or bimonthly, as they will

be educating patients about the benefits of the change and viral suppression and arranging care to

maintain consistency in treatment. Such leadership is also applicable in promoting policy

transformation in the healthcare organizations to incorporate long-acting injectables (LAIs) into

the regular practices, which would allow increasing the patient engagement and slowing the

disease progression. As an example, they may describe the side effects of the injection and offer

emotional support to the patient, which encourages trust and enhances the experience of care

(Nachega et al., 2023). Additionally, nurses are the mainsprings of quality enhancement since

they gather real-time adherence and satisfaction data with the help of tools such as electronic

health records (EHRs) and the Patient Satisfaction Questionnaire Short Form (PSQ-18) to guide

iterative adjustments (Marshall & Hays, 1994).

The Cabenuva intervention plan has a beneficial impact on nursing practice and interprofessional

cooperation. In the case of nurses, they no longer have to remind patients to take pills; instead,

they are involved in special injection administration and comprehensive monitoring, which

means they have to receive special training in injection administration and side effect

management, which increases their scope of practice (Baker et al., 2025). This improves job

satisfaction and professional growth, and nurses will become part of multidisciplinary teams.

Cabenuva requires more active cooperation between nurses, physicians, pharmacists, and social

workers interprofessionally. Doctors order and monitor the viral load tests, pharmacists do the

ordering and storing of the drugs, and nurses do the injections and the follow-ups. This

teamwork model minimizes silos, which has been observed in multi-site studies in which shared

EHRs and team huddles enhanced communication and patient outcomes (Slama et al., 2023).

There is also increased involvement of payers and administrators as they assess

cost-effectiveness in order to promote sustainability.

The healthcare field gains substantially from this plan through improved efficiency, equity, and

outcomes. Cabenuva's long-acting nature reduces healthcare utilization by minimizing

emergency visits and hospitalizations associated with non-adherence, potentially lowering costs

by 10% as targeted in the evaluation plan (Nachega et al., 2023). It advances health equity by

addressing barriers for underserved populations, such as those facing stigma or transportation

issues, leading to sustained viral suppression in over 90% of users and reduced transmission risks

(Baker et al., 2025). Overall, this intervention promotes resource-efficient care, aligns with

Health Resources and Services Administration (HRSA) standards for HIV management, and sets

a precedent for innovative ART modalities (U.S. Department of Health and Human Services,

2025).

Future Steps

To amplify the project's impact on the target population of virally suppressed adults with HIV

and leverage emerging technologies and care models, several enhancements could be

implemented. Currently, the six-month evaluation focuses on clinic-based injections and

mixed-methods data collection; however, expanding to a larger cohort or multi-site rollout would

increase generalizability and reach more vulnerable individuals. The incorporation of telehealth

in pre- and post-injection consultations would eliminate access barriers, as the side effects could

be monitored remotely and adherence reminders could be provided through video calls, hence

enhancing safety and convenience.

New technologies provide good opportunities to optimize. AI might be used to identify the risks

of adherence based on the patterns of EHR data, and this could be used to intervene in a

proactive manner through personalized alerts (Nachega et al., 2023). Rapid HIV antigen

detectors utilizing nanomechanical platforms could be used in the form of point-of-care

diagnostic instruments that would allow testing viral loads on-site during injections, eliminating

lab bottlenecks and improving outcome monitoring (Baker et al., 2025). Moreover, mobile care

clinics might expand to the rural or underserved communities, breaking the geographical barrier

and enhancing equity in HIV prevention and treatment (U.S. Department of Health and Human

Services, 2025). The integration of technology-aided interventions, such as app-based symptom

reporting in combination with EHRs, would facilitate data collection and real-time changes to

care plans (Slama et al., 2023). These measures are consistent with the development of care

models involving community responses and evidence-based investments that could slow down

the progress of the disease and enhance safety through less exposure.

Reflection on Leading Change and Improvement

The capstone project has not only changed my life, but it has also enabled me to become a better

leader of change in both my personal practice and future leadership roles. The experience of

designing and evaluating the implementation of Cabenuva helped me to develop my abilities in

evidence-based advocacy since I had to synthesize the information obtained during the analysis

of EHRs, surveys, and interviews to influence the enhancement of adherence and satisfaction. At

a personal level, it instilled the confidence of conducting multidisciplinary talks, such as focus

groups with nurses, which provided implementation barriers like workflow interference. This

experience will be applicable in future positions, where I can spearhead such innovations,

possibly in the field of public health nursing, by promoting patient-centered technologies and by

establishing collaborative cultures.

The final intervention, implementation, and evaluation plans can be easily applied to my

personal practice to facilitate quality improvement in different settings. As another example, the

mixed-methods approach, which employs both quantitative measures such as viral loads and

qualitative data on stigma, can be scaled to address the management of chronic diseases such as

diabetes, where the use of injectable forms of medication is essential. In community health, the

stakeholder approach, which includes patients, providers, and payers, can guide the programs

based on opioid use disorder, considering the reduced utilization and satisfaction. These plans

offer a roadmap to a scalable, equitable enhancement in care delivery to various healthcare

sectors by combining different resources, including HRSA benchmarks and recent research on

LAIs (Slama et al., 2023).

Conclusion

In summary, implementing Cabenuva empowers nurses to lead transformative changes in HIV

care, fostering better adherence, collaboration, and equity. Future integrations of technology and

expanded models promise broader impacts, while personal growth in leadership ensures

sustained improvements. This approach not only aligns with evidence-based standards but also

paves the way for innovative, patient-centered healthcare solutions.

References

Baker, D., Collins, L. F., Cantos, V. D., Hollenberg, E., Kaplan, A., Cowan, T., ... & Lora,

M. (2025). Early implementation of long-acting injectable cabotegravir for HIV

prevention in a safety net hospital-based primary care center in US South. Journal of

General Internal Medicine, 1-10.

https://link.springer.com/article/10.1007/s11606-025-09350-8

Marshall, G. N., & Hays, R. D. (1994). The Patient Satisfaction Questionnaire Short

Form (PSQ-18). RAND Corporation.

https://www.rand.org/content/dam/rand/pubs/papers/2006/P7865.pdf?utm_medium=emai

l&utm_source=transaction

Nachega, J. B., Scarsi, K. K., Gandhi, M., Scott, R. K., Mofenson, L. M., Archary, M., ...

& Mellors, J. W. (2023). Long-acting antiretrovirals and HIV treatment adherence. The

Lancet HIV, 10(5), e332-e342.

https://www.thelancet.com/journals/lanhiv/article/PIIS2352-3018(23)00051-6/abstract

Slama, L., Porcher, R., Linard, F., Chakvetadze, C., Cros, A., Carillon, S., ... & Molina, J.

M. (2023). Injectable long acting antiretroviral for HIV treatment and prevention:

perspectives of potential users. BMC Infectious Diseases, 23(1), 98.

https://doi.org/10.1186/s12879-023-08071-9

U.S. Department of Health and Human Services. (2025). Health Resources and Services

Administration: HIV/AIDS Bureau. https://hab.hrsa.gov/

INTERVENTION

Capstone Intervention Plan: Long-Acting Injectable Cabenuva for HIV Management

This Capstone intervention plan evaluates monthly long-acting injectable Cabenuva versus daily

oral antiretroviral therapy for virally suppressed adults with HIV, focusing on improving

medication adherence and viral suppression over six months at an urban outpatient clinic. By

integrating evidence-based nursing frameworks and advanced technologies, the plan addresses

cultural, ethical, and policy barriers to deliver equitable, patient-centered care. Strategic

leadership and stakeholder collaboration drive the initiative to enhance health outcomes for a

vulnerable population.

Intervention Plan Components

Core Components

The intervention introduces long-acting injectable Cabenuva (cabotegravir and rilpivirine) for

virally suppressed adults with HIV at the AIDS Healthcare Foundation (AHF) clinic. It tackles

adherence challenges of daily oral antiretroviral therapy (ART) by offering monthly injections.

Key components include patient selection, education, medication administration, monitoring, and

resource coordination. Eligible adults are identified through electronic health records, followed

by nurse-led education on Cabenuva’s benefits, administration process, and potential side effects,

such as injection site reactions. Trained nurses administer intramuscular injections using sterile

techniques. Monthly follow-ups track adherence via appointment attendance and viral

suppression through viral load tests, supported by counseling and mobile reminders. The clinic

secures Cabenuva through the Ryan White HIV/AIDS Program (RWHAP) and manages

refrigerated storage requirements.

Cultural Considerations

The target population, often including racial minorities and low-income individuals, faces stigma

and socioeconomic barriers. Education materials are tailored to diverse literacy levels and

provided in multiple languages to enhance accessibility. Flexible scheduling and transportation

assistance accommodate unstable living situations, ensuring equitable access (U.S. Department

of Health and Human Services, 2024). Private injection settings mitigate stigma, fostering patient

trust and engagement in care.

Theoretical Foundations

Theoretical Frameworks

The intervention aligns with Orem’s Self-Care Deficit Theory, which emphasizes nursing

support when self-care demands exceed capabilities (Hartweg & Metcalfe, 2022). Cabenuva

reduces the burden of daily pill-taking, while nurse-led education addresses knowledge deficits.

Motivational interviewing, a psychological approach, enhances adherence by exploring barriers

like stigma and motivations for treatment (Reinauer et al., 2021). Technologies, including

electronic health record alerts and mobile apps, ensure operational efficiency.

Evidence-Based Justification

According to the National Institutes of Health (2023), long-acting injectable ART (LAI-ART)

maintains viral suppression and improves adherence, particularly for patients with adherence

challenges. Nurse-led counseling is an established strategy for ART adherence, as demonstrated

in HIV prevention programs (Centers for Disease Control and Prevention, 2025). These findings

validate the intervention’s focus on injectable therapy supported by nursing and technological

strategies.

Stakeholders, Policy, and Regulations

Stakeholder Needs and Impact

Stakeholders significantly influence the intervention’s success, including patients, nurses, clinic

administrators, and payers like Medicaid and RWHAP. Patients require convenient, stigma-free

care, necessitating private injection settings and flexible scheduling within the intervention plan.

Nurses need training to administer injections safely, requiring professional development

programs that impact the education component (Chang et al., 2024). Administrators must address

procurement and storage challenges, such as refrigerated storage for Cabenuva, affecting

resource coordination. Payers determine coverage, influencing patient access to the medication,

which shapes the intervention’s scalability. These needs ensure the intervention aligns with

stakeholder priorities, enhancing implementation feasibility (U.S. Department of Health and

Human Services, 2024).

Regulatory Implications and Potential Support

Regulatory frameworks and governing bodies, including the Centers for Medicare & Medicaid

Services (CMS) and the Health Resources and Services Administration (HRSA), impact the

intervention. CMS oversees billing compliance, requiring accurate electronic health record

documentation for reimbursement, which affects the monitoring component. HRSA’s guidance

through RWHAP supports equitable LAI-ART distribution, providing potential funding for

medication procurement (U.S. Department of Health and Human Services, 2025). However,

state-level variations in Medicaid and AIDS Drug Assistance Program (ADAP) coverage, often

requiring prior authorization, pose regulatory barriers that could delay implementation. Potential

support includes RWHAP grants and HRSA technical assistance, which can streamline

procurement and training, enhancing intervention success.

Policy Considerations

Existing RWHAP policies partially support Cabenuva access but are inconsistent across states,

limiting equitable distribution (U.S. Department of Health and Human Services, 2024). The

intervention proposes new policy considerations to address these gaps. At the state level, policies

should mandate Cabenuva inclusion in all Medicaid and ADAP formularies without prior

authorization to reduce access barriers. Federally, increasing RWHAP funding would bolster

medication availability and clinic resources. Advocacy engaging HRSA and state health

departments would support the intervention’s implementation by ensuring consistent access and

financial sustainability.

Ethical and Legal Implications

Ethical Considerations

Equitable access to Cabenuva is critical, as cost and coverage barriers may disproportionately

affect low-income or minority patients, exacerbating disparities. Informed consent requires clear

communication about benefits and risks, including injection site reactions. Stigma necessitates

discreet injection administration to protect patient privacy.

Legal Considerations

Nurses must comply with state regulations for injection administration and maintain accurate

electronic health record documentation for Centers for Medicare & Medicaid Services (CMS)

billing. Non-coverage by payers could raise legal concerns about discriminatory care practices,

particularly for underserved groups.

Mitigation Strategies

Sliding-scale payment options and advocacy for expanded coverage address access issues.

Secure electronic health record systems and private injection settings safeguard confidentiality,

aligning with Health Insurance Portability and Accountability Act (HIPAA) standards.

Management and Leadership

Leadership Strategies

Transformational leadership fosters interprofessional collaboration. Nurse leaders train staff on

Cabenuva administration, coordinate with pharmacists for procurement, and engage social

workers for patient support. Monthly team meetings address challenges, promoting innovation

and alignment with project goals.

Change Management

Transitioning to Cabenuva requires workflow adjustments, such as scheduling injections and

updating electronic health records, potentially increasing initial nurse workload. Improved

adherence and viral suppression enhance care quality and reduce long-term costs, like

hospitalizations. Cost control leverages RWHAP funding and optimizes clinic resources (U.S.

Department of Health and Human Services, 2024).

Delivery and Technology

Delivery Methods

The intervention involves in-clinic injections by trained nurses, supported by telehealth for

follow-up counseling to accommodate patient schedules. Community outreach, including flyers

and support groups, promotes enrollment and awareness, ensuring broad reach.

Technological Integration

Electronic health records track appointments and viral loads, while mobile apps send adherence

reminders. Emerging technologies, such as automated text-based nudges, could enhance

engagement. Telehealth facilitates remote monitoring, reducing clinic visits for stable patients

(National Institutes of Health, 2023), aligning with care efficiency goals.

Timeline

Implementation Schedule

The six-month plan includes:

● Month 1: Identify patients, train staff, provide education, and conduct baseline viral load

testing.

● Months 2–5: Administer monthly injections, provide counseling, monitor adherence and

side effects, and perform viral load tests.

● Month 6: Evaluate outcomes (adherence and viral suppression rates vs. oral ART),

analyze data, and disseminate findings.

Influencing Factors

Timing depends on staff training, medication procurement, and enrollment. Delays from payer

approvals or supply chain issues are mitigated by early advocacy and RWHAP support.

Conclusion

This intervention plan harnesses Cabenuva’s potential to improve adherence and viral

suppression for adults with HIV. By addressing cultural, ethical, and policy barriers with

evidence-based nursing and technological strategies, it enhances care quality and equity.

Stakeholder collaboration, policy advocacy, and robust leadership ensure sustainable,

patient-centered outcomes.

References

Centers for Disease Control and Prevention. (2025). HIV prevention: Pre-exposure

prophylaxis (PrEP).

https://www.cdc.gov/hiv/prevention/prep.html#:~:text=PrEP%20is%20for%20adults%20

and,during%20pregnancy%2C%20or%20while%20breastfeeding.

Chang, Y. Y., Chao, L. F., Chang, W., Lin, C. M., Lee, Y. H., Latimer, A., & Chung, M.

L. (2024). Impact of an immersive virtual reality simulator education program on nursing

students' intravenous injection administration: A mixed methods study. Nurse Education

Today, 132, 106002. https://doi.org/10.1016/j.nedt.2023.106002

Hartweg, D. L., & Metcalfe, S. A. (2022). Orem’s self-care deficit nursing theory:

relevance and need for refinement. Nursing science quarterly, 35(1), 70-76.

https://doi.org/10.1177/08943184211051369

National Institutes of Health. (2023). Long-acting injectable antiretroviral therapy for

HIV. https://doi.org/10.1186/s12879-023-08071-9

Reinauer, C., Platzbecker, A. L., Viermann, R., Domhardt, M., Baumeister, H., Foertsch,

K., ... & Meissner, T. (2021). Efficacy of motivational interviewing to improve utilization

of mental health services among youths with chronic medical conditions: a cluster

randomized clinical trial. JAMA network open, 4(10), e2127622-e2127622.

https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2784614

U.S. Department of Health and Human Services. (2024). Ryan White HIV/AIDS Program

services report. https://ryanwhite.hrsa.gov/about/recipient-resources

U.S. Department of Health and Human Services. (2025). Health Resources and Services

Administration: HIV/AIDS Bureau. https://hab.hrsa.gov/

U.S. Department of Health and Human Services. (2025). State Medicaid and AIDS Drug

Assistance Program formularies.

https://ryanwhite.hrsa.gov/about/parts-and-initiatives/part-b-adap