Improving receipt of 6-weeks DNA-PCR HIV test results among HIV Exposed Infants at Mulanje District Hospital, version 1.0
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Date
2022-07-18
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Kamuzu University of Health Sciences
Abstract
This is a quality improvement project using a quasi-experimental pre-and
post-intervention assessment. The continuum of care in an HIV-exposed infant, i.e., from DNA-PCR testing to
attaining results and being initiated on Antiretroviral drugs, has many bottlenecks where
infants may be lost to follow-up. One of the challenges is the untimely communication of
DNA-PCR results to mothers/caregivers of HIV-exposed infants. Untimely communication
of DNA-PCR results to caregivers of HIV-exposed infants is associated with delayed ART
initiation. Hence, HIV-positive infants are at a high risk of morbidity and mortality.To evaluate strategies that increase the percentage of mother's/caregivers of
HIV-exposed infants receiving 6-week DNA-PCR test results by 20% from July 2022 to
March 2023 at Mulanje District Hospital.
Specific objectives:
1. To assess the baseline process of testing an HIV-exposed Infant at six weeks of age to
the mother/caregiver of the HIV-exposed infant, getting the results at Mulanje District
Hospital.
2. To identify change ideas for improving HIV-exposed Infants' 6-week DNA-PCR test
results communication to mother/caregiver at Mulanje District Hospital.
3. To describe quality improvement models for improving receipt of DNA-PCR test
results by caregivers of HIV-exposed infants.
4. To measure the percentage of HIV-exposed infants receiving a 6-week HIV DNAPCR
test results after implementing change ideas.
Methods: We will formulate and train a Work Improvement Team with members comprising
ART providers (nurses and clinicians), laboratory staff, HIV Diagnostic Assistants, Health
Surveillance Assistants and Expert Clients from Mulanje district hospital. We will analyse
routinely collected patient data to identify barriers to communication of results and areas for
improvement using the Plan-Do-Study-Cycle. We will then implement change ideas and
collect data at the end of the implementation period. Having completed all the above, we will
describe quality improvement models for improving receipt of DNA-PCR test results by are givers of HIV-exposed infants using the Consolidated Framework of Implementation
Research. We anticipate that the Work improvement team will
implement change ideas to improve the communication of results to caregivers. We will
recommend the scale-up/adoption of change ideas of high impact and low effort. We will disseminate the results to Mulanje District Health Office
stakeholders and the College of Medicine Research Ethics Committee. We also plan to
submit an abstract and a manuscript to peer-reviewed national conferences and scientific
journals.
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Keywords
Receiving of HIV PCR results for infants