Clinical Outcomes of a Nurse-Delivered, Technology-Enabled HIV Outpatient Model.

IF 2.2 Q3 INFECTIOUS DISEASES Journal of the International Association of Providers of AIDS Care Pub Date : 2024-01-01 DOI:10.1177/23259582241274304

Sara Day, Rebecca Wilkins, Andrew Murungi, Christina Antoniadi, Yodit Fissahaye-Yimer, Samuel Ohene-Adomako, David Asboe, Caroline Rae

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Abstract

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.

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由护士提供的技术辅助型艾滋病门诊模式的临床效果。

我们对 Klick 进行了评估，这是一种以护士为主导的数字化艾滋病门诊护理模式，于 2020 年推出。Klick 的智能手机应用程序提供在线预约、远程护士咨询和结果。我们根据 BHIVA 监测指南对 Klick 护士主导的咨询进行了审核，并就护士的经验进行了访谈。在接受审核的 40 名 Klick 患者中，有 4 人达到了 BHIVA 的 5 项标准：100%的患者记录了共同用药、吸烟史、血压和病毒载量数据，89%的患者接受了心血管风险计算（目标97%-90%-90%-90%-90%）。与全国 BHIVA 审计结果相比，克里克在 24 项可比指标中的 22 项指标上表现更佳。护士们安全地管理了一批具有一定复杂性的患者（如合并疾病、多重药物治疗）；没有病例脱离治疗路径，而且所有病例都得到了病毒抑制。利用数字化支持模式，护士有效地为健康状况基本稳定的 HIV 阳性患者提供了安全护理，使顾问能够专注于更复杂的病例。护理工作全面且以人为本，与之前的全国性审计相比，取得了更好的成果。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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