Document Type

Dissertation

Degree

Doctor of Nursing Practice

Major

Nursing

Date of Defense

7-12-2018

Graduate Advisor

Laura Kuensting

Committee

Louise Miller

Patricia Plumley

Abstract

Abstract

Problem. Providing housing to otherwise homeless individuals who are HIV/AIDS-positive has been demonstrated to improve control of the disease. This was a healthcare quality initiative to review the viral load and Cluster of Differentiation Protein Four positive (CD4+) counts over time of residents in an urban housing facility for HIV/AIDS-positive individuals. Also, a nurse-run clinic was introduced for residents, especially those with comorbidities such as hypertension and diabetes.

Methods. A repeated measures design was utilized. Viral loads and CD4+ counts were retrospectively reviewed from facility records at entrance into and five-years later at the facility. Additionally, measurements of blood pressure, blood glucose, and glycosylated hemoglobin (HgbA1C) were obtained from visits to the facility’s nurse-run clinic over nine-weeks.

Results. Twenty-nine residents and their families resided in the housing unit (N=29). There was no statistically significant association between housing and improved viral loads (t (2) = -.321, p = .779) and CD4+ counts (t (1) = -2.538, p = .239). Further, nurse clinic usage was low (n=6) and did not provide adequate data for analysis of blood pressure, blood glucose, and HgbA1C monitoring.

Implications for Practice. There were limitations in services provided in the nurse-run clinic which may have contributed to its low utilization by the residents. Providing an advanced practice registered nurse (APRN) may increase services offered and improve clinic utilization. Missed appointments, unrecorded measurements, and improperly recorded lab values contributed to missing data which may have affected data analysis. A more standardized process for record keeping might improve health maintenance.

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