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推进以护士从业者为基础的模式的案例,以加速艾滋病毒暴露前预防的推广。

Advancing the case for nurse practitioner-based models to accelerate scale-up of HIV pre-exposure prophylaxis.

机构信息

University of Rochester, Rochester, New York.

出版信息

J Clin Nurs. 2019 Jan;28(1-2):351-361. doi: 10.1111/jocn.14675. Epub 2018 Oct 11.

Abstract

AIMS

To explore the factors that position nurse practitioners (NPs) to lead the implementation of HIV pre-exposure prophylaxis.

BACKGROUND

The HIV epidemic represents a global health crisis. Reducing new HIV infections is a public health priority, especially for Black and Latino men who have sex with men (MSM). When taken as directed, co-formulated emtricitabine and tenofovir have over 95% efficacy in preventing HIV; however, substantial gaps remain between those who would benefit from pre-exposure prophylaxis (PrEP) and current PrEP prescribing practices.

DESIGN

This is a position paper that draws on concurrent assessments of research literature and advanced practice nursing frameworks.

METHOD

The arguments in this paper are grounded in the current literature on HIV PrEP implementation and evidence of the added value of nurse-based models in promoting health outcomes. The American Association of Colleges of Nursing's advanced nursing practice competencies were also included as a source of data for identifying and cross-referencing NP assets that align with HIV PrEP care continuum outcomes.

CONCLUSIONS

There are four main evidence-based arguments that can be used to advance policy-level and practice-level changes that harness the assets of nurse practitioners in accelerating the scale-up of HIV PrEP.

RELEVANCE TO CLINICAL PRACTICE

Global public health goals for HIV prevention cannot be achieved without the broader adoption of PrEP as a prevention practice among healthcare providers. NPs are the best hope for closing this gap in access for the populations that are most vulnerable to HIV infection.

摘要

目的

探讨使执业护士(NP)能够领导实施艾滋病毒暴露前预防的因素。

背景

艾滋病流行是全球卫生危机。减少新的艾滋病毒感染是公共卫生的重点,尤其是对于与男性发生性关系的黑人男性和拉丁裔男性(MSM)。如果按照指示服用,富马酸替诺福韦二吡呋酯和恩曲他滨复方制剂在预防艾滋病毒方面的有效性超过 95%;然而,在那些将从暴露前预防(PrEP)中受益的人和目前的 PrEP 处方实践之间仍然存在很大差距。

设计

这是一份立场文件,借鉴了对研究文献和高级护理实践框架的同时评估。

方法

本文中的论点基于关于 HIV PrEP 实施的当前文献以及基于护士的模式在促进健康结果方面的附加值的证据。美国护理学院协会的高级护理实践能力也被包括在内,作为确定和交叉引用与 HIV PrEP 护理连续体结果一致的 NP 资产的数据源。

结论

有四个主要的基于证据的论点,可以用来推动政策层面和实践层面的变革,利用执业护士的资产来加速 HIV PrEP 的推广。

相关性到临床实践

如果医疗保健提供者不更广泛地将 PrEP 作为预防措施,就无法实现预防艾滋病毒的全球公共卫生目标。NP 是为最容易感染艾滋病毒的人群提供这种获取途径的最大希望。

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