Date of Award
2024
Document Type
Doctor of Nursing Practice (DNP)
Degree Name
Doctor of Nursing Practice (DNP)
Department
Nursing
Committee Chair
Joseph Chamness
Subject(s)
HIV infections--Prevention, Pre-exposure prophylaxis, Hospitals--Emergency services, Hospitals--Diagnostic services
Abstract
The United States faces a significant public health challenge with the prevalence of Human Immunodeficiency Virus (HIV), particularly in the Southern region. Shelby County, Tennessee, has the highest number of HIV cases in the state. Despite the initial approval of Pre-Exposure Prophylaxis (PrEP) for HIV prevention by the FDA in 2012, the adoption of PrEP has been low due to various barriers. The barriers include a lack of identification of patients at risk for HIV, screening for PrEP eligibility, and insufficient provision of PrEP resources by healthcare providers. The emergency department (ED) at Baptist Memorial Hospital-Memphis did not have a standardized protocol for screening patients for PrEP eligibility, providing education on PrEP, and connecting at-risk patients to PrEP resources, which resulted in missed opportunities for HIV prevention. To address this, a Doctor of Nursing (DNP) evidenced-based project aimed to increase PrEP referrals and uptake for high-risk sexually active patients by implementing a PrEP eligibility screening and referral protocol at Baptist Memorial ED over twelve weeks. The participants included 121 registered nurses and twenty-two healthcare providers, including three nurse practitioners (NPs), four physician assistants (PAs), and fifteen medical doctors (MDs) who were rotating staff in the emergency department at Baptist Memorial Hospital-Memphis. Outcomes were measured through PrEP eligibility screenings, referrals, education, and uptake. Post-implementation, 105 patients received PrEP eligibility screenings; 48 patients were identified as high risk through screening (compared to 34 pre-implementation), 58 patients received PrEP referrals (compared to zero previously), and 89 patients received PrEP education, increasing awareness. However, one patient kept an appointment at the Shelby County Health Department PrEP clinic and started PrEP uptake over the twelve weeks. The findings showed a positive impact on PrEP screening, referrals, education, and increasing PrEP awareness. The implications of these results are further discussed.
Recommended Citation
Kimber, Alisha D., "Implementation of a pre-exposure prophylaxis (PrEP) screening and referral protocol in emergency department patients" (2024). Doctor of Nursing Practice (DNP). 127.
https://louis.uah.edu/uah-dnp/127