Community Nursing Practice

Introduction to Community Nursing Practice

This is the case of Jennifer, who was 30 years of an old female who attended a sexual health clinic for a consultation with the community health nurse. At the time of her consultation, Jennifer was diagnosed with the Human Immunodeficiency Virus (HIV) ten years ago. Now, Jennifer had a relationship with Ben and there is a risk of Ben getting affected with the virus. Jennifer did not take any medications that were prescribed to her like antiretroviral medications and some investigations. She did not follow any of the procedures like medications and investigations because she was living far away from the healthcare facility in a remote location. So, she was nor able to travel to the nearest medical center which was four hours away, and did not obtain any medical procedures as prescribed. Now, a few days back she returned to Melbourne for work and wants to seek support from healthcare professionals. A community health nurse is the first point of contact for a patient suffering from an illness (Tarkang & Zotor, 2015). So, in this essay, the role of community health nurses in preventive healthcare and screening will be involved along with strategies that will help Ben and Jennifer in prevention from HIV in a relationship.

Community Nursing Practice - Part A

Human Immunodeficiency Virus (HIV) is a chronic disease that needs a patient-centric approach to be followed in care. The patients are related and responsible for taking the role of their primary manager if they are suffered from this chronic disease. There is an imbalance of power between patients, healthcare workers, and the community to build good relationships and help them in strengthening community structures in ways they support long-term self and patient management (Schmidt, McIver & Houghton et al., 2018). Nursing professionals in the case of Jennifer and Ben will play a pivotal role play role in preventing HIV, identifying, and treating them by providing coordinated care so that they have the best prevention and treatment outcomes. The Code of ethics for nursing professionals also describes the roles that they have to present in assessing care needs and coordinating care delivery. The nursing professional to play a role in the prevention of HIV focus on a healthy and safe environment. They practice collaboratively and parallelly to ensure that principles of inclusion and cultural diversity are followed. Australia is the country where diversity of people resides in the country (Kushwaha, Lalani & Maina et al., 2017). Two types of people are there such as Indigenous and non-Indigenous groups. The nursing professional have to here ensure that they provide care to all people without any discrimination on the grounds of culture, race, ethnicity, gender, and many more. Jennifer and Ben must be given proper care in healthcare facilities to maximize their health outcomes and minimize health disparities.

Nursing professionals must demonstrate respect and compassion for the inherent dignity of all patients. They ensure to promote health, safety, and rights of the patient by collaborating to protect human rights, reduction in health disparities, and promotion of health diplomacy (Seidman, Carlson & Weber et al., 2016). The nursing professionals ensure that they integrate principles of social justice into health policy and nursing care of HIV patients like Jennifer. Nurses play a role in educating patients about HIV, assisting with navigation of care delivery, and providing support for treatment adherence. The nurse will provide patient-centered counseling as an important part of the testing process and will do testing for HIV and Viral Hepatitis for both. In the care of Jennifer and Ben, nursing professionals will acquire updated training in evidence-based prevention strategies to assist them in following tailored plans to reduce harm/ risk of HIV/ viral hepatitis (Wilson, Bleasdale & Przybyla, 2020). The nursing professional here has to routinely assess Jennifer and Ben for HIV, viral hepatitis, and risk of sexual behavior, and needle use. Jennifer herself reported that she contacted Ben for a physical relationship and has not taken any treatments including investigations and medications for HIV infection. So, HIV and viral hepatitis of both should be tested as they engaged in high-risk behavior. The plan of community nurse involves education and interventions for patients including HIV and viral hepatitis prevention that includes harm and risk reduction as an appropriate measure (Holloway, Winder & Lea et al., 2017). The community nurse plan of care also includes the provision of prevention strategies, messages, positive reinforcement of changes to safer behavior, and education regarding risk/harm reduction. Before starting with the testing of the patient, Jennifer and Ben must be given information that the HIV test has to be done about what the test is, the necessity of test, and the usage of the test. The nurse offers information to the patient an information sheet that provides information about an HIV test. The medical record will indicate that HIV testing has been given to the patient, and the patient has consented to test verbally (Bazzi, Biancarelli & Childs et al., 2018).

The community nurse educates on the barriers to HIV prevention, and present leadership roles within systems of care to improve cultural, access, and quality competence. Moreover, community nurse is also made responsible for policymaking by implementation, development, and incentivizing high-quality with high-value care coordination. This ensures support and encouragement with full practice by rewarding and recognizing the role of community nurses in delivering high-value HIV. Nursing professionals are an integral part of HIV care coordination for the optimization of patient outcomes (Forrest, Wiens & Kanters et al., 2015). They prepare to lead interdisciplinary teams and supervision of others that involves stewardship and care coordination in the effective and efficient use of healthcare resources. They take a leadership role in the design, implementation, and evaluation of team-based care coordination for Jennifer and Ben with the integration of behavioral and physical health. The community nurse ensures that in this case Jennifer and Ben remain in care, maintain viral suppression, and adhere to their medications and clinical processes. They ensure that Jennifer and Ben are treated for HIV related and non-HIV related conditions with community support in care (World Health Organization, 2016). One of the major things is they acknowledge that homophobia, sexual, racism, and stigma objectification that impacts the healthcare delivery system to them. Hence, education, systems of care, policy-making, testing for HIV and viral Hepatitis and referral to care, access to care, advocacy, care coordination, and treatment is provided to Ben and Jennifer based on their HIV status (World Health Organization, 2016).

Community Nursing Practice - Part B

There are several strategies that the nursing professional should follow to support Ben and Jennifer in preventive health about HIV. The strategies are condom usage, STI screening and treatment, use of antiretroviral therapy, and information, education, and communication (World Health Organization, 2016). This is the strategy and a step that Jennifer and Ben should follow for the control of HIV transmission and initiating the risk of high sexual risk behavior. This is the behavior that gives greater benefits in getting treatment for sexually transmitted diseases with the certainty of averting the mortality and morbidity caused directly by sexually transmitted diseases rather than indirectly because of reduced HIV transmission. This will also help in cost-effectiveness to prevent and minimize the risk of getting affected by infection (Scheim, Santos & Arreola et al., 2016).

The use of antiretroviral drugs is the evidence-based provision to reduce the transmission vertically. Being sexually active now, Jennifer can also get pregnant so she must consider this point that she should prevent mother-to-child-transmission. This method is very useful with the point of cost-saving as she was already infected from HIV for a long time. This will also help in the falling prevalence of HIV falls and cost-effectiveness because like her other women will also get motivated and reach hospitals to avail of medical services. This will help in easy detection and screening of HIV infected women (Enah, Piper & Moneyham, 2015).

Jennifer and Ben are a couple, so the nursing professional should educate them regarding the use of condoms in HIV prevention. This is a cost-effective method that is purchased at a low cost and has high effectiveness in HIV prevention. The different approaches and information on relative costs have increased the use of condoms by serodiscordant sexual partners is not available, and the use of the product is more useful than any other. This will also be a cost-effective method for reduction in cervical cancer and sexually transmitted diseases. These strategies present more reliable information on the optimization of cost-effectiveness and effectiveness of condom programs (Schmidt, McIver & Houghton et al., 2018).

Education, information, and communication are some of the most effective strategies that include education on HIV/ AIDS and condom use through counseling and sharing brochures. This will help in boosting the purchase, promotion, and distribution of condoms (Forrest, Wiens & Kanters et al., 2015). Here, the role of the behavior change model will come as Jennifer and Ben are unaware of the particular behavior that it can be dangerous to their health. This is the complicated process that includes sensitization on personal issues like the couple was having. Here, the community nurse should opt for this strategy to promote the population and individuals along the continuum of behavior change. The couple is here not fully aware of HIV/ AIDS and its dangerous effects. Here, the point interpersonal communication will play a greater role in training them for sexually transmitted diseases (Tarkang & Zotor, 2015). The second step will involve concern, and this is the step when the information will be shared with the audience as it applies to them. This way the couple will become more concerned and motivated to evaluate their behavior. This will likely be effective in creating concern and overcoming denial, particularly for those who are at greater risk like Jennifer and Ben. This is known that individuals acquire more knowledge and skills when they interact with healthcare workers because they discuss all the concerns with them. Interpersonal communication is highly needed at this stage to be effective in training programs by building knowledge of sex and sexuality responsibly. Then, the couple will start getting concerned about the need to protect them and their loved ones from sexually transmitted diseases. This is the time when individuals will get completely motivated towards change. They will think about this concern for a long time and decide not to perform the sexual activity without condom (Santisteban & Cianelli et al., 2015). Condom is a thing that is easily available in the market and to make individuals feel comfortable with sex. Then the stage will come that is trail change behavior, this is the later stage in which the couple will encounter to purchase condoms for safe sex and change in behavior. The healthcare professional has to consider this point that the couple should try this for a long time. The knowledge shared with the couple should be full of experience and skills. This will result in the adoption of behavior and the couple will finally remain faithful to this strategy regularly (Schmidt, McIver & Houghton et al., 2018).

Conclusion on Community Nursing Practice

Planning, implementation, and execution of the plans and the strategies are possible with the collaborative efforts of healthcare providers and consumers. The awareness programs will help in motivating the couple for the utilization of services. Understanding these elements will ensure motivation towards change programs by the couple. Community health nurses being the first point of contact for patients suffering from an illness will be helpful in this case. She is the case of Jennifer and Ben will play a pivotal role play role in preventing HIV, identifying, and treating them by providing coordinated care so that they have the best prevention and treatment outcomes. The plan of community nurse will involve education and interventions for patients including HIV and viral hepatitis prevention that includes harm and risk reduction as an appropriate measure. The barriers to HIV prevention, and present leadership roles within systems of care to improve cultural, access, and quality competence by community nurse with the means of education. The strategies like condom usage, STI screening and treatment, use of antiretroviral therapy, and information, education, and communication will benefit them in prevention from getting Ben affected and further transmission of the virus. Contribution to service will result in the adoption of behavior and the couple will finally remain faithful to this strategy regularly.

References for Community Nursing Practice

Bazzi, A. R., Biancarelli, D. L., Childs, E., Drainoni, M. L., Edeza, A., Salhaney, P., ... & Biello, K. B. (2018). Limited knowledge and mixed interest in pre-exposure prophylaxis for HIV prevention among people who inject drugs. AIDS Patient Care and STDs32(12), 529-537. https://doi.org/10.1089/apc.2018.0126

Enah, C., Piper, K., & Moneyham, L. (2015). Qualitative evaluation of the relevance and acceptability of a web-based HIV prevention game for rural adolescents. Journal of Pediatric Nursing30(2), 321-328. https://doi.org/10.1016/j.pedn.2014.09.004

Forrest, J. I., Wiens, M., Kanters, S., Nsanzimana, S., Lester, R. T., & Mills, E. J. (2015). Mobile health applications for HIV prevention and care in Africa. Current Opinion in HIV and AIDS10(6), 464-471. 10.1097/COH.0000000000000198

Geter, A., Herron, A. R., & Sutton, M. Y. (2018). HIV-related stigma by healthcare providers in the United States: A systematic review. AIDS Patient Care and STDs32(10), 418-424. https://doi.org/10.1089/apc.2018.0114\

Holloway, I. W., Winder, T. J., Lea III, C. H., Tan, D., Boyd, D., & Novak, D. (2017). Technology use and preferences for mobile phone-based HIV prevention and treatment among black young men who have sex with men: Exploratory research. JMIR mHealth and uHealth5(4), e46. https://mhealth.jmir.org/2017/4/e46

Kushwaha, S., Lalani, Y., Maina, G., Ogunbajo, A., Wilton, L., Agyarko-Poku, T., ... & Nelson, L. E. (2017). “But the moment they find out that you are MSM…”: A qualitative investigation of HIV prevention experiences among men who have sex with men (MSM) in Ghana’s health care system. BMC Public Health17(1), 770. https://link.springer.com/article/10.1186/s12889-017-4799-1

Scheim, A. I., Santos, G. M., Arreola, S., Makofane, K., Do, T. D., Hebert, P., ... & Ayala, G. (2016). Inequities in access to HIV prevention services for transgender men: results of a global survey of men who have sex with men. Journal of the International AIDS Society19, 20779. https://doi.org/10.7448/IAS.19.3.20779

Schmidt, H. M. A., McIver, R., Houghton, R., Selvey, C., McNulty, A., Varma, R., ... & Holden, J. (2018). Nurse-led pre-exposure prophylaxis: A non-traditional model to provide HIV prevention in a resource-constrained, pragmatic clinical trial. Sexual Health15(6), 595-597. https://doi.org/10.1071/SH18076

Seidman, D., Carlson, K., Weber, S., Witt, J., & Kelly, P. J. (2016). United States family planning providers' knowledge of and attitudes towards preexposure prophylaxis for HIV prevention: A national survey. Contraception93(5), 463-469. https://doi.org/10.1016/j.contraception.2015.12.018

Tarkang, E. E., & Zotor, F. B. (2015). Application of the health belief model (HBM) in HIV prevention: A literature review. Central African Journal of Public Health1(1), 1-8. 10.11648/j.cajph.20150101.11

Villegas, N., Santisteban, D., Cianelli, R., Ferrer, L., Ambrosia, T., Peragallo, N., & Lara, L. (2015). Pilot Testing an internet‐based STI and HIV prevention intervention with Chilean women. Journal of Nursing Scholarship47(2), 106-116. https://sigmapubs.onlinelibrary.wiley.com/doi/abs/10.1111/jnu.12114

Wilson, K., Bleasdale, J., & Przybyla, S. M. (2020). Provider-patient communication on pre-exposure prophylaxis (Prep) for HIV prevention: An exploration of healthcare provider challenges. Health Communication, 1-10. https://doi.org/10.1080/10410236.2020.1787927

World Health Organization. (2016). Consolidated guidelines on the use of antiretroviral drugs for treating and preventing HIV infection: Recommendations for a public health approach. World Health Organization. https://apps.who.int/iris/bitstream/handle/10665/208825/9789241549684_eng.pdf

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