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符合条件的HIV阳性成年人的HPV疫苗接种:一个最佳实践实施项目。

HPV vaccination among eligible HIV-positive adults: a best practice implementation project.

作者信息

Walker Holly, Garbo Candon, Palokas Michelle

机构信息

School of Nursing, University of Mississippi Medical Center, Jackson, MS, USA.

Mississippi Centre for Evidence-Based Practice: A JBI Centre of Excellence, Jackson, MS, USA.

出版信息

JBI Evid Implement. 2023 Dec 29. doi: 10.1097/XEB.0000000000000403.

Abstract

OBJECTIVE

The aim of this best practice implementation project was to promote evidence-based practices (EBPs) for human papilloma virus (HPV) vaccination among eligible HIV-positive patients.

INTRODUCTION

HPV-induced cancers are largely preventable by prophylactic vaccination of HPV-naïve individuals. Immunosuppression in HIV-positive patients prevents clearance of HPV, which increases the risk of developing cancer. Health care agencies caring for individuals living with HIV must implement interventions to enhance uptake of HPV vaccination.

METHODS

This project was guided by the JBI Model of Evidence-Based Healthcare and JBI's Getting Research into Practice (GRiP) tool. A baseline audit was conducted to assess current practice against EBPs and to identify areas for improvement. A follow-up audit was used post-implementation to determine whether compliance with EBPs improved.

RESULTS

The baseline audit revealed an average compliance rate of 46% with the two EBPs for increasing vaccination uptake. Three barriers to compliance were identified and strategies were implemented to address these barriers. The follow-up audit revealed 71% average compliance with the EBPs, a 25% increase from baseline.

CONCLUSIONS

Interventions aimed at promoting HPV vaccination among HIV-positive individuals can reduce the risk of specific cancers. This project revealed an increase in compliance with EBPs for HPV vaccination for eligible HIV-positive patients when a vaccination reminder and recall system was placed in a frequently visited section of the electronic health record. However, a more sustainable solution would be to collaborate with the information technology staff to ensure that the health maintenance section in the electronic health record is configured correctly.

摘要

目的

本最佳实践实施项目的目的是在符合条件的HIV阳性患者中推广人乳头瘤病毒(HPV)疫苗接种的循证实践(EBP)。

引言

HPV引发的癌症在很大程度上可通过对未感染HPV的个体进行预防性疫苗接种来预防。HIV阳性患者的免疫抑制会阻碍HPV的清除,从而增加患癌风险。为感染HIV者提供护理的医疗机构必须实施干预措施,以提高HPV疫苗接种率。

方法

本项目以循证医疗保健的JBI模型和JBI的将研究转化为实践(GRiP)工具为指导。进行了一次基线审核,以评估当前实践与循证实践的符合情况,并确定改进领域。实施后进行了一次随访审核,以确定对循证实践的依从性是否有所提高。

结果

基线审核显示,在提高疫苗接种率的两项循证实践方面,平均依从率为46%。确定了三个依从性障碍,并实施了相应策略来解决这些障碍。随访审核显示,对循证实践的平均依从率为71%,比基线提高了25%。

结论

旨在促进HIV阳性个体接种HPV疫苗的干预措施可降低特定癌症的风险。本项目表明,当在电子健康记录中经常访问的部分设置疫苗接种提醒和召回系统时,符合条件的HIV阳性患者对HPV疫苗接种循证实践的依从性有所提高。然而,更可持续的解决方案是与信息技术人员合作,确保电子健康记录中的健康维护部分配置正确。

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