A Nurse-Led Initiative to Improve Implementation of HIV Preconception Care Services

Area of Science:

• Public Health
• HIV Medicine
• Primary Care

Background:

• United States guidelines emphasize preconception care (PCC) for improved maternal and fetal outcomes.
• Individuals living with HIV require specialized PCC, yet its integration into HIV care remains inconsistent.
• Limited research exists on effective strategies for enhancing PCC delivery within HIV settings.

Purpose of the Study:

• To describe a successful nurse-led initiative to improve preconception care (PCC) implementation in an urban HIV clinic.
• To highlight strategies for integrating specialized PCC into primary care for individuals with HIV.
• To provide a model for other HIV primary care clinics seeking to enhance PCC services.

Main Methods:

• A nurse-led initiative employing collaborative strategic planning, staff education, and continuous quality improvement (CQI).
• Key activities included consensus building, training, action planning, addressing clinic-specific barriers, and providing ongoing support.
• CQI reviews were conducted at 12, 18, and 36 months to assess implementation.

Main Results:

• Demonstrated improved and sustained implementation of PCC services for both women and men at all CQI review points.
• The initiative successfully integrated specialized PCC into the clinic's primary care services.
• The project identified key features for successful PCC implementation in HIV care settings.

Conclusions:

• Nurse-led initiatives incorporating strategic planning and CQI can effectively strengthen PCC implementation in HIV care.
• The described approach offers a replicable model for HIV primary care clinics aiming to enhance PCC.
• Sustained improvements in PCC delivery are achievable through targeted interventions and ongoing quality monitoring.