Chelsea and Westminster Hospitals, NHS Foundation Trust, London, UK.
ViiV Healthcare, Brentford, UK.
J Int Assoc Provid AIDS Care. 2024 Jan-Dec;23:23259582241274304. doi: 10.1177/23259582241274304.
We evaluated Klick, a nurse-led, digitally enabled model of HIV outpatient care, launched in 2020. Klick's smartphone app offers online booking, remote nurse-led consultations, and results. An audit of Klick nurse-led consultations was conducted against BHIVA monitoring guidelines, and nurses were interviewed about their experience. Of 40 Klick patients audited, 4 of 5 BHIVA standards were met: 100% had documented co-medications, smoking history, blood pressure, and viral load data, and 89% received a cardiovascular risk calculation (Targets 97%-90%-90%-90%-90%). Compared to national BHIVA audit findings, Klick performed better across 22 of 24 comparable measures. Nurses safely managed a cohort comprising some complexity (eg, co-morbidities, polypharmacy); no cases were escalated off the pathway, and all were virologically suppressed. Using a digitally supported model, nurses effectively provided safe care to HIV-positive patients with predominantly stable health, enabling consultants to focus on more complex caseloads. Care was comprehensive and person-centered and obtained better outcomes compared to previous national audits.
我们评估了 Klick，这是一种 2020 年推出的由护士主导、数字化支持的 HIV 门诊护理模式。Klick 的智能手机应用程序提供在线预约、远程护士主导的咨询和结果。根据 BHIVA 监测指南，对 Klick 护士主导的咨询进行了审核，并对护士的经验进行了采访。在接受审核的 40 名 Klick 患者中，有 5 项 BHIVA 标准中的 4 项得到了满足：100%记录了合并用药、吸烟史、血压和病毒载量数据，89%接受了心血管风险计算（目标 97%-90%-90%-90%-90%）。与全国性的 BHIVA 审核结果相比，Klick 在 24 项可比指标中的 22 项表现更好。护士安全地管理了一组包括一些复杂性的患者（例如合并症、多种药物治疗）；没有病例从该途径升级，所有患者的病毒载量均得到抑制。通过使用数字化支持的模型，护士能够有效地为 HIV 阳性患者提供安全的护理，这些患者的健康状况主要稳定，使顾问能够专注于更复杂的病例。护理是全面的和以患者为中心的，与之前的全国性审核相比，取得了更好的结果。
