Given their large numbers and presence across systems of care, nurses are uniquely positioned to address barriers to care faced by lesbian, gay, bisexual and transgender people. Modules such as the one described here can be used by nurse faculty to guide the inclusion of lesbian, gay, bisexual and transgender-specific content in family nurse practitioner or other nursing courses-as well as to guide the development of nursing competencies in the care of lesbian, gay, bisexual and transgender people.
Enrollment in Doctor of Nursing Practice (DNP) programs is growing rapidly. This poses a challenge to faculty because there is a gap in knowledge about evidence-based practice and quality improvement DNP projects. Challenged by the growing unavailability of preceptors and mentors in the practice setting, solutions are needed to help students meet the essentials of the degree and competencies for practice. Faculty knowledge of key DNP quality improvement project elements, measuring, monitoring, and sustaining improvement outcomes, may help students design projects to provide value to practice partners. A literature review was conducted to identify gaps in faculty knowledge of potential practice partners' value-added elements of DNP quality improvement projects (measuring, monitoring, and sustainability) to make recommendations for faculty development to improve DNP project mentoring. There is evidence in the literature that faculty feel ill-prepared to mentor DNP projects. Quality improvement content is available for faculty development in the nursing and other health sciences literature. Optimizing faculty knowledge regarding evidence-based practice, quality improvement processes, and mentoring of sustainable DNP projects that improve health care provides value to practice partners and may advance long-term partnerships. Adding structures to support faculty knowledge in these areas contributes to solutions to the challenges of rapidly expanding DNP programs.
The COVID-19 pandemic forced the US health care system to evaluate alternative care delivery strategies to reduce the risk of coronavirus transmission to patients and health care providers. Telehealth modalities are a safe and effective alternative to face-to-face visits for primary and psychiatric care. Federal policy makers approved changes to telehealth reimbursement coverage and allowed flexibility of location for patients and providers. This article describes the transition of patient visits to telehealth by nurse practitioner faculty at an academic medical center to maintain continuity of care of underserved patient populations. This pivot facilitated resumption of clinical learning experiences for nurse practitioner students.
Human immunodeficiency virus (HIV) pre-exposure prophylaxis (PrEP) with emtricitabine/tenofovir (TDF/FTC) can reduce HIV infection risk by 92% in people at high risk for HIV. TDF/FTC was approved for HIV PrEP by the Food and Drug Administration in 2012. Primary care nurse practitioners (NPs) have not embraced this tool for the prevention of new HIV infection. A number of barriers exist that may prevent primary care NPs from prescribing HIV PrEP for patients in need. This article clarifies current recommendations for HIV PrEP and provides practical guidance for primary care NPs to incorporate this tool into their routine practice.
Consistent dosing of tenofovir/emtricitabine-based HIV pre-exposure prophylaxis (PrEP) can reduce HIV infection risk by up to 92%. However, clinical trials have shown low PrEP adherence (34–71%), resulting in reduced effectiveness. To improve PrEP's effectiveness, adherence to a daily PrEP regimen is essential. This report explores patients' patterns of PrEP initiation and use and their PrEP-related perceptions to provide greater understanding of patient motivations for beginning and adhering to PrEP. At two urban primary care clinics, individual coaching sessions that included semistructured interviews were offered to 10 PrEP patients. Regarding PrEP initiation, 30% of patients were advised to use PrEP by their nurse practitioners (NPs), while the remaining patients requested PrEP themselves. Before they initiated PrEP, all patients were familiar with it through social contacts or internet-based research. Patients' PrEP-related perceptions were identified, including perceived pros and cons of PrEP use, and degrees of PrEP knowledge, uncertainty, and fear. Primary care NPs should take detailed sexual histories to avoid overlooking PrEP candidates. In addition, primary care NPs should introduce easy-to-access, Internet-based resources to reinforce patient education. Last, PrEP promotional campaigns should be focused at the community level in gay, bisexual, transgender and queer populations.
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