The Perinatal Nurse’s Role The Perinatal Nurse’s Role in the Prevention of HIV in the Prevention of HIV vertical Transmission vertical Transmission Ana Rua Dobles, RN,ACRN Ana Rua Dobles, RN,ACRN HUG Me Program HUG Me Program Arnold Palmer Hospital Arnold Palmer Hospital Orlando, Florida Orlando, Florida [email protected][email protected]
9
Embed
The Perinatal Nurse’s Role in the Prevention of HIV vertical Transmission Ana Rua Dobles, RN,ACRN HUG Me Program Arnold Palmer Hospital Orlando, Florida.
This document is posted to help you gain knowledge. Please leave a comment to let me know what you think about it! Share it to your friends and learn new things together.
Transcript
The Perinatal Nurse’s Role in the The Perinatal Nurse’s Role in the Prevention of HIV vertical Prevention of HIV vertical
TransmissionTransmission
Ana Rua Dobles, RN,ACRNAna Rua Dobles, RN,ACRNHUG Me ProgramHUG Me Program
Arnold Palmer HospitalArnold Palmer HospitalOrlando, FloridaOrlando, Florida
A study conducted in four states A study conducted in four states (Michigan, New Jersey, Louisiana, (Michigan, New Jersey, Louisiana, and South Carolina) found that and South Carolina) found that the proportion of pregnant women the proportion of pregnant women voluntarily tested for HIV voluntarily tested for HIV increased from 68% in 1993 to increased from 68% in 1993 to 79% in 1996. The percentage of 79% in 1996. The percentage of women offered AZT increased women offered AZT increased from 27% in 1993 to 85% in 1996.from 27% in 1993 to 85% in 1996.
However, the study also However, the study also found that 15% of HIV-found that 15% of HIV-infected pregnant women in infected pregnant women in these states did not receive these states did not receive prenatal care and therefore prenatal care and therefore could not be offered this could not be offered this intervention.intervention.
Community resourcesCommunity resources
Dedicated Personnel
Healthy Start Programs
WIC Programs
Private Practice Clinicians, Clinics, Hospitals, Ob Centers
Health Insurance
AIDS Service Organizations
ADAP
Points of interventionPoints of intervention
Preconception CarePreconception Care
Protocol 076
Prenatal IntrapartumPost Partum- Baby
Any entity, agent, service, institution, or system that touches my patient I need to interact with
Zero Transmission StrategiesZero Transmission Strategies
PrenatalPrenatal
Track referralsTrack referrals Establish contact prior to visit Establish contact prior to visit Discuss first visit Discuss first visit Meet at prenatal visitMeet at prenatal visit Orient to protocol and prenatal Orient to protocol and prenatal
care processcare process Address concernsAddress concerns Collaborate with MD for care Collaborate with MD for care
planplan AdherenceAdherence Establish open access – pagerEstablish open access – pager Be present at each visitBe present at each visit Track missed visitsTrack missed visits Engage in care planEngage in care plan Education!!Education!!
Notify admission to NurseNotify admission to NurseERERTriageTriageLabor RoomLabor RoomUrgent careUrgent careNewborn Nurseries- NICU, Newborn Nurseries- NICU,
ECNECN Transition NurseryTransition NurseryMother/Baby UnitsMother/Baby Units
Vaginal Delivery
C-Section
Rapid testing needed ?
Provide Staff support for Protocol implementation
Discharge Plan
Post partum-BabyPost partum-Baby
Ensure Ensure Pediatric Team is notifiedPediatric Team is notified AZT started for infantAZT started for infant Review f.u. per protocol with Review f.u. per protocol with
mothermother Counsel for infant HIV testCounsel for infant HIV test Obtain consent for HIV PCR Obtain consent for HIV PCR
RNA RNA Discharge PlanDischarge Plan
AZT administration AZT administration do’s/don’t’sdo’s/don’t’s
Provide 6 week supply AZTProvide 6 week supply AZT Provide dose marked Provide dose marked
syringes, spill proof capsyringes, spill proof cap Arrange f.u. appointmentArrange f.u. appointment Post discharge callPost discharge call
Post partum- MotherPost partum- Mother
Discharge PlanDischarge Plan P/P self careP/P self care Arrange for P/P f.u.Arrange for P/P f.u. Primary/HIV care for Primary/HIV care for