Chronic Disease Management - HIV/AIDS

Chronic Disease Management - HIV/AIDS
Student:
Professor:
Course title:
Date:
Table of Contents
 TOC \o "1-3" \h \z \u  HYPERLINK \l "_Toc406073744"
Abstract  PAGEREF _Toc406073744 \h
4
 HYPERLINK \l "_Toc406073745"
Chronic Disease Management - HIV/AIDS  PAGEREF _Toc406073745 \h
5
 HYPERLINK \l "_Toc406073746"
1.0 Problem Description  PAGEREF _Toc406073746 \h
5
 HYPERLINK \l "_Toc406073747"
1.1 Impact of the problem  PAGEREF _Toc406073747 \h
6
 HYPERLINK \l "_Toc406073748"
1.2 Gravity of the problem  PAGEREF _Toc406073748 \h
7
 HYPERLINK \l "_Toc406073749"
2.0 Solution Description  PAGEREF _Toc406073749 \h
7
 HYPERLINK \l "_Toc406073750"
2.1 Explanation of proposed solution  PAGEREF _Toc406073750 \h
7
 HYPERLINK \l "_Toc406073751"
2.2 Rationale for selecting proposed solution  PAGEREF _Toc406073751 \h
8
 HYPERLINK \l "_Toc406073752"
3.0 Implementation Plan  PAGEREF _Toc406073752 \h
10
 HYPERLINK \l "_Toc406073753"
3.1 Method of obtaining necessary approval and securing support  PAGEREF _Toc406073753 \h
10
 HYPERLINK \l "_Toc406073754"
3.2 Evidence from review of literature  PAGEREF _Toc406073754 \h
11
 HYPERLINK \l "_Toc406073755"
3.3 Implementation logistics  PAGEREF _Toc406073755 \h
12
 HYPERLINK \l "_Toc406073756"
3.4 Resources needed for implementation  PAGEREF _Toc406073756 \h
13
 HYPERLINK \l "_Toc406073757"
4.0 Evaluation Plan  PAGEREF _Toc406073757 \h
13
 HYPERLINK \l "_Toc406073758"
4.1 Methods to evaluate effectiveness of the proposed change  PAGEREF _Toc406073758 \h
13
 HYPERLINK \l "_Toc406073759"
4.2 Variables to be assessed when evaluating project outcomes  PAGEREF _Toc406073759 \h
15
 HYPERLINK \l "_Toc406073760"
4.2.1 Perceptions and attitudes of staff members  PAGEREF _Toc406073760 \h
15
 HYPERLINK \l "_Toc406073761"
4.2.2 Perceptions and attitudes of the HIV/AIDS patients  PAGEREF _Toc406073761 \h
16
 HYPERLINK \l "_Toc406073762"
4.3 Tools to educate project participants and evaluate project outcomes  PAGEREF _Toc406073762 \h
16
 HYPERLINK \l "_Toc406073763"
4.3.1 Tools to educate participants  PAGEREF _Toc406073763 \h
16
 HYPERLINK \l "_Toc406073764"
4.3.2 Tools to assess the project outcomes  PAGEREF _Toc406073764 \h
16
 HYPERLINK \l "_Toc406073765"
5.0 Dissemination Plan  PAGEREF _Toc406073765 \h
16
 HYPERLINK \l "_Toc406073766"
6.0 Review of Literature  PAGEREF _Toc406073766 \h
18
 HYPERLINK \l "_Toc406073767"
7.0 Conclusion  PAGEREF _Toc406073767 \h
26
 HYPERLINK \l "_Toc406073768"
8.0 References  PAGEREF _Toc406073768 \h
27
 HYPERLINK \l "_Toc406073769"
9.0 Appendices  PAGEREF _Toc406073769 \h
30
 HYPERLINK \l "_Toc406073770"
9.1 Appendix A: Interview to evaluate the project outcomes  PAGEREF _Toc406073770 \h
30
 HYPERLINK \l "_Toc406073771"
9.2 Appendix B: Questionnaire to evaluate the project outcomes  PAGEREF _Toc406073771 \h
31

Abstract
The current problem is the usual care in the management of HIV/AIDS. Patients who present at the health care facility with HIV/AIDS symptoms are provided with Anti-Retroviral Therapy (ART) to manage the disease. HIV/AIDS is also managed through routine measuring of HIV viral load and CD4 counts. Drugs are also utilized in the prevention of opportunistic infections and opportunistic infections are often treated whenever they arise. No education or teaching is provided to the patients in this current situation. The proposed solution entails providing teaching to HIV/AIDS patients for the purpose of improving the level of educational awareness, reducing complications, and enhancing the quality of life of the patient. The outcomes of the proposed solution are also related to an increased nursing staff satisfaction and patient satisfaction.
Support from the hospital’s top management and colleagues would be obtained by addressing their concerns unequivocally and adequately, and by clearly explaining the rationale for the proposed solution and the reason why the proposed solution is actually necessary and vital for the hospital. The HIV/AIDS patients need education in order to be informed about safer sex and the transmission of HIV/AIDS. This education will help them to avoid getting in contact with a HIV strain that is different from the strain they already have, and to know how they can live positively without transmitting the virus on to others. To evaluate the effectiveness of the proposed solution, the level of educational awareness of the patients and the quality of their lives would be assessed prior to the implementation of the proposed solution in the hospital setting and after the implementation. The findings of the research would be disseminated though publication in well-known journals; using a website; using media coverage such as television and video; organizing and attending conferences to discuss the findings; and preparing pamphlets.
Keywords: chronic disease, HIV/AIDS, teaching, educational awareness, quality of life
Chronic Disease Management - HIV/AIDS
1.0 Problem Description
In this project, the current problem is the usual care in the management of HIV/AIDS. This means that patients who present at the health care facility with HIV/AIDS symptoms are provided with Anti-Retroviral Therapy (ART) to manage the disease. AIDS is essentially the most serious and the last stage of HIV disease, which brings about extensive damage to a person’s immune system (Bach et al., 2013). AIDS in America is the 5th leading cause of death amongst people aged between 25 – 44. Worldwide, roughly 47 million individuals have been infected with HIV from the time when the epidemic started (Harris, 2013). At present, AIDS does not have a cure. Nonetheless, several available treatments exist that could actually help in delaying the progression of the illness for some years as well as improve the life quality of those who have been infected and have shown symptoms (Biggs, 2012). ART is known to suppress the HIV virus inside the individual’s body. A mix of many antiretroviral agents commonly referred to as Highly Active Anti-Retroviral Therapy (HAART) is extremely effective in lowering the amount of HIV particles within the blood stream as measured by viral load. This helps the immune system of the patient to bounce back for some time and improve the T-cells counts (Biggs, 2012). HAART does not cure HIV/AIDS and people using this medication could still pass the virus on to other people when sharing needles or through unprotected sexual intercourse.
Moreover, at present, HIV/AIDS is also managed through routine measuring of HIV viral load and CD4 counts – this blood test measures the amount of the HIV virus within the patient’s blood. HIV viral load and CD4 counts are taken after each 3-4 months with the goal of getting the CD4 count as close to normal as possible and suppressing the HIV viral load to an undetectable level (Harris, 2013). In addition, drugs are also utilized in the prevention of opportunistic infections and they could keep the patients with AIDS to live healthier for a long time. Opportunistic infections are often treated whenever they arise. No education or teaching is provided to the patients in this current situation.
The management of the ever-increasing chronic health complications has been a major challenge among modern healthcare professionals and most specifically nurses. Moreover, recent studies reveal that chronic disease management is the most costly and challenging health plan in the contemporary healthcare institutions (Swendeman, Ingram & Rotheram, 2009). Chronic diseases have as well turned out to be an epidemic of unparalleled proportion in developed nations such as the United States. However, despite being among the most challenging health conditions, studies reveal that a good number of healthcare practitioners lack the necessary skills for managing chronic diseases. Limited number of professionals with the relevant knowledge for managing chronic diseases has subsequently led to increased preventable and premature deaths in the contemporary healthcare facilities (Salzman, Collins & Hajjar, 2012). Chronic diseases are human health challenges that are long lasting. The management of chronic health complications is the process of ensuring that the identified health problems have minimum effects on the patients’ health (Nuovo, 2007). In most instances, the term chronic is applicable when a health condition lasts for more than three months. Some of the popular chronic diseases include HIV/AIDS, diabetes, COPD, arthritis, cancer and asthma (Salzman, Collins & Hajjar, 2012).
1.1 Impact of the problem
Chronic diseases have severe and regrettable social, political, and economic effects on families and the entire society. In the extreme cases, chronic diseases result in physical dysfunction and pre-mature deaths. Studies have demonstrated that modern governments spend most of their resources in facilitating and supporting chronic diseases management. For instance, studies reveal that the United States spends over $ 2 trillion annually in the management of chronic conditions. Chronic conditions have also contributed greatly in reducing life expectancy in developed states (Redman, 2013).
1.2 Gravity of the problem
So far, chronic diseases are the major causes for the increased mortality rate in the world. In addition, reports from WHO indicate that the number of chronic diseases have been increasing significantly in the last five decades. In addition, reports indicate that in 2005, chronic diseases contributed to over 55% of the total global deaths (Cramm, 2014). The available statistical evidences further suggest that over 40% of elderly people in the United States are suffering from chronic complications. Additionally, the available data reveals that chronic complications are becoming common among young people. For instance, the 2012 world report indicates that young children under the age of ten years are suffering from diabetes (Nuño et al., 2012)
2.0 Solution Description
2.1 Explanation of proposed solution
The proposed solution entails providing teaching to HIV/AIDS patients for the purpose of improving the level of educational awareness, reducing complications, and enhancing the quality of life of the patient. The outcomes of the proposed solution are also related to an increased nursing staff satisfaction and patient satisfaction. Due to the provision of education, the patients will be helped to live positively without transmitting the virus on to somebody else. In addition, the patients will be informed on how they can prevent themselves from getting a different strain of the virus than the strain they already have. It is worth mentioning that if the infected person continues to have unprotected sex, she/he may get a different strain of the disease that may be difficult to treat/manage (Harris, 2013).
2.2 Rationale for selecting proposed solution
Patients with HIV/AIDS will be provided with teaching and education to help in preventing the spread of the disease. Hawkins (2011) pointed out that the expansion as well as improvement of HIV/AIDS education worldwide is fundamental in preventing HIV/AIDS. At present, there are roughly 34 million persons around the world who live with the virus, and millions more persons become infected yearly (Biggs, 2012). Effective education on HIV/AIDS could be useful in preventing new HIV infections.
The proposed solution of providing education and teaching to HIV/AIDS patients was selected since it could help the HIV/AIDS patients to live positively without transmitting the virus on to somebody else. Providing education and teaching to those already infected will also help the HIV/AIDS patients to prevent themselves from getting infected with different strains of the virus. Equally important, it will help in ensuring a good quality of life for those already infected by informing them about medication as well as the support which is available to them (Melenyk & Fineout-Overholt, 2010).
In order to minimize the current regrettable effects of chronic health challenges, modern health institutions require reliable health projects for minimizing their effects. Therefore, an effective and reliable multi-disciplinary regional project is the most appropriate mechanism for dealing with the regrettable effects of chronic diseases especially among elderly people. An effective multi-disciplinary approach will be significant in helping nurses redesign and improve their support care program. The program will provide workshop for educating healthcare professionals on the most reliable means of managing chronic health complications. The project’s main objective will be to facilitate the innovation of primary care for chronic diseases management. The project will also offer an avenue for educating healthcare professionals on the most reliable means of preventing the spread of chronic diseases especially among young people.
The project also aims at facilitating collaboration and teamwork among healthcare professionals in dealing with chronic diseases. Collaboration among healthcare professionals will equally be useful in minimizing chronic diseases management cost. In addition, a workshop held will help in educating nurses on some of the most reliable strategies for managing the available resources. The chronic disease management project will also help in the refining workshop formats in order to ensure intensive and mutual consultations among all stakeholders. The inclusion of varying ideas among healthcare professionals will be essential in coming up with appropriate mechanisms for minimizing some of the regrettable effects of chronic diseases to the society.
In addition, long post workshop interval will be vital in advancing healthcare skills on the management of chronic diseases. The multi-disciplinary approach will also offer evidence-based care. Evidence based care will ensure that healthcare professionals undertake detailed assessment on the patients’ health condition before starting the treatment process (Wallace et al., 2013). In addition, the project aims at ensuring that chronic diseases management program get the necessary support from the relevant authorities. So far, a good number of modern governments have set aside the necessary resources for supporting chronic diseases mitigation programs. The project also aims at educating community members on the most effective means of preventing chronic diseases. In most instances, individual life style is the main cause for the ever-increasing chronic complications (Jones, 2011).
3.0 Implementation Plan
3.1 Method of obtaining necessary approval and securing support
This project’s success depends very much on the support of the main stakeholders consisting of the top management of the hospital and colleagues who basically include physicians and nursing staff members. They are all very important considering that they will need to support and approve the project in order that the implementation of the project is ultimately a success. Support from the hospital’s top management, physicians, nurses, nurse assistants, and other healthcare workers at the hospital would be obtained using three approaches. Since some staff members and managers at the hospital may be worried and feel disquieted regarding the implementation of the change at the facility, the first approach will entail addressing their concerns unequivocally and adequately. This is important since it would help in reducing the likelihood of resistance from the managers and employees at the health facility (Holloway & Wheeler, 2009).
The second approach is by clearly explaining the rationale for the proposed solution and the reason why the proposed solution is actually necessary and vital for the hospital. I will enlighten the key stakeholders about the significance of the proposed change and how they all stand to benefit once the change is fully implemented and espoused at the facility. Thirdly, I will obtain support and approval from the hospital’s managers and employees by consulting them and engaging them throughout the process of implementation. This will ensure that they actually have a feeling of contribution to the project as well as ownership of the project, which is of major importance to the success of this project (DiSanza & Legge, 2011).
3.2 Evidence from review of literature
Education is of major importance to an effective response to the HIV/AIDS epidemic. Bach et al. (2013) stated that education and teaching on HIV/AIDS is actually required to improve the life quality of those already infected with this virus. Usually, teaching about HIV/AIDS is considered as being something that has to targeted only at those individuals who are not infected to prevent them from getting infected with the virus. Melenyk & Fineout-Overholt (2010) observed that whenever HIV/AIDS education and teaching those already infected is considered at all, it is too often considered only in terms of preventing new HIV infections by teaching those infected about the significance of not transmitting the virus to other people. A commonly-neglected and significant facet of HIV/AIDS education with those already infected is enabling and empowering them in improving their quality of life. It is worth mentioning that HIV/AIDS patients have different educational needs, and some of these needs are the need of being able to access drug provision and medical services, as well as the need of being able to find apt practical and emotional support and help (Radebe, 2009).
Biggs (2012) also reported those who people who live with HIV/AIDS need education. To begin with, this education should involve an element of counseling as well as support. The education should also teach the infected people how to live well with the virus, the necessary tests which they might need to have, as well as the drugs that they might require to take (Biggs, 2012). Furthermore, the HIV/AIDS patients also need to be informed about safer sex and the transmission of HIV/AIDS largely for 2 reasons. First, these already infected people need to know how they can avoid getting in contact with a HIV strain that is different from the strain they already have, and secondly, these patients need to know how they can live positively without transmitting the virus on to others (Melenyk & Fineout-Overholt, 2010). In essence, HIV/AIDS education and prevention go together in reducing the number of new cases of the disease whilst helping in improving the lives of those already infected with the disease.
3.3 Implementation logistics
Integrating the proposed change into the organization’s existing structure, workflow, and culture is essentially the responsibility of the organization’s top management. The top management will have to implement rules and policies that would incorporate the change into the organization’s existing workflow, culture, and structure. The other way in which the proposed change can be integrated is through the use of manipulation and castigatory measures. With this approach, staffs at the healthcare facility would be manipulated into accepting the proposed change. Those who try to resist it will face punitive actions such as being fired from work.
Thirdly, the proposed change can be integrated into the organization’s existing structure, workflow, as well as culture by informing the staff members the importance of the change to them and to the hospital at large. By providing education and teaching to HIV/AIDS patients at the hospital, the cost of care the hospital incurs in treating the HIV/AIDS patients will reduce since the education will help to reduce HIV/AIDS-related complications and improve the quality of life of the patient (Harris, 2013). The other way to integrate the same is by rewarding those staff members who readily accept the change. This will serve to encourage other staffs, especially those who are resistant, to accept the change.
Two key personnel are of major significance to this project. The hospital’s charge nurse and nurse manager will have the responsibility of initiating the change process, educating the nursing staffs, and to oversee the change implementation process. The responsibility of the nurse manager will be to initiate the change process and then develop a common vision for the hospital. The role of the charge nurse will be to oversee the change implementation process and ensure that it is done acceptably.
3.4 Resources needed for implementation
Financial resources: this project is expected to cost roughly $42,332. The financial resources would cover the costs of preparing the educational materials and in disseminating the research results to the stakeholders and the wider nursing community. Personnel: the hospital’s healthcare workers (HCW) – charge nurses, nursing assistants, therapists, physicians, and nurses – would all be needed in the process of implementing the change. Educational materials: the educational materials that would be needed include handouts and leaflets. Assessment tool: a questionnaire would be prepared as an assessment tool.
4.0 Evaluation Plan
4.1 Methods to evaluate effectiveness of the proposed change
The proposed solution for this project basically entails providing teaching to HIV/AIDS patients for the purpose of improving the level of educational awareness, reducing complications, and enhancing the quality of life of the HIV/AIDS patient. Therefore, to evaluate the effectiveness of the proposed solution, the level of educational awareness of the patients and the quality of their lives would be assessed prior to the implementation of the proposed solution in the hospital setting and after the implementation. The educational awareness of the patients suffering from HIV/AIDS before the implementation would be compared to their educational awareness after the implementation of the proposed solution. This means that if the patients have a higher level of educational awareness after the implementation of the proposed solution compared to before the implementation, then it would be considered as a success and effective. Conversely, if their level of educational awareness remains as it was before the implementation, then the proposed solution would not be considered as effective (Holloway & Wheeler, 2009).
The other method that would be used to measure the effectiveness of the proposed change is by assessing the patients’ quality of life before and after the implementation of the proposed solution. This means that if the quality of life of the HIV/AIDS patients will have improved following the implementation of the proposed solution, it would be considered to have been effective. Conversely, the proposed solution will be considered as not effective if the patients’ quality of life would have worsened or remained just like it was before the implementation of the proposed solution (Harris, 2013). The third method to be used in evaluating the effectiveness of the proposed solution is by assessing the complications of the HIV/AIDS patients prior to and after implementation of the proposed solution. In essence, if the complications of the patients will have reduced after the implementation of the proposed solution, then it would be considered to have been effective. Conversely, if the complications of the patients would have increased or would have actually remained the same as they were prior to the implementation of the proposed solution, then it would not be seen to have been effective.
Furthermore, the strains of HIV/AIDS that the patients have before and after the implementation of the proposed solution would be compared. It is noteworthy that the provision of education is also aimed at helping the HIV/AIDS to live positively without transmitting the virus on to somebody else. The patients will also be educated on how they can prevent themselves from getting a different strain of the virus than the strain they already have. As such, the proposed solution will be considered to have been ineffective if the patients have a different strain of the HIV/AIDS virus following the implementation of the proposed solution. It will imply that they engaged in unprotected sexual intercourse with other people which resulted in them getting a different strain of the disease, and they may have passed the virus on to other people who were previously uninfected (Biggs, 2012).
Another metho...