Nursing_Research_Study_Contribution

Nursing Research Study Contributions Preventing Mother -to -Child Transmission of HIV in Resource –Limited settings: The Elizabeth Glaser Pediatric AIDS foundation Experience Mother-to –Child transmission takes place while an HIV infected women transfer the virus to her baby. This can occur during pregnancy, labor and throughout breast-feeding. If infected women are not treated, there are more chances of the babies being infected during pregnancy, delivery and breast-feeding. This is seen mostly in resource-limited countries. In 1999, the Elizabeth Glaser pediatric AIDS foundation started a service based systematic effort to resource-limited countries to reduce the mother to child transmission of HIV infection. This study reviewed six and a half years of one of the world’s largest programmes for the prevention of mother to child transmission(PMTCT) of HIV, methods of the research, HIV counseling, antiretroviral prophylaxis, data collection, technical assistance. Methods and research design Elizabeth Glaser Pediatric AIDs foundation (EGPAF) was co founded in 1988 and it has developed and managed by so many of peer-reviewed research and implementation programme worldwide. Both quantitative and qualitative methods of research are used in this study. In September 1999 ,the foundation spend one million dollars to begin a multicountry, service based effort to reduce the prenatally acquired HIV infection in the developing world. EGPAF requested help from governmental, nongovernmental, faith-based, and international organizations and health care facilities in order to plan implement and expand PMTCT programme. By 2006, EGPAF had supported 22 resource-limited countries. The programmes included are HIV counseling and testing and antiretroviral prophylaxis in to maternal and child health clinics. Every PMTCT facility recorded the patient’s information in prenatal clinics, labor and delivery, about counseling, HIV status and antiretroviral prophylaxis, and presented the statistics to organization personnel for the quantitative progress report for EGPAF. (Spensley et al., 2009) Contribution to Nursing practice This study contributed to nursing in many ways.The programme trained health care providers.HIV conselling made the women to be aware of the seriousness of the disease and the importance of taking antiretroviral prophylaxis in order to decrease the chance of mother to child transmission.Women attending prenatal care received general health education,information about HIV and messages for primary prevention.Pre and post test HIV counseling was given individualy or as a group.Women are informed that HIV testing was an integral part of standard antenatal care and they can opt out if wanted without losing the other services.Addressing infant feeding were given to mothers because one third to one half of mother to child transmission occur through breast feeding.Nurse midwife,nurses,physicians,medical officers,trained nonmedical personnel and trained birth attendants were essential to provide these services in PMTCT locations. (Spensley et al., 2009) HIV testing enabled the nursing practice to be aware of the precausions to be taken and to estimate the amount of medication to be kept ready.Most PMTCT fecilities used rapid HIV antibody testing which gives the results on the same day ,increasing the proportion of women getting the results.Most countries currenly employ serial testing allowing nurses to perform HIV test.Retroviral prophylaxis with single dose Nevirapine were given to HIV infected women during antenatal care and at the onset of labor under direct supervision by a nurse or a trained personal.Traditional birth attendants are encouraged to train and participate these activities in areas like Cameroon and Tanzania where they provide pre and postnatal care. (Spensley et al., 2009) Data collection was done quarterly or semi annually. EGPAF’s technical assistants collects these data, sample data to ensure accuracy, and provide technical assitance to address findings or concerns.The technical adviser reviews and submits programme data to EGPAF’s evaluation staff and programme staff in the United States collaboratevely analyse the data and create summary. (Spensley et al., 2009).These findings will contribute to nursing practice. Contribution to Patient Outcome As of 2006, EGPAF’s multinational PMTCT programme in 22 resource- limited countries showed a tremedous scope of stopping mother to child transmission of HIV. The foundation –affiliated services were used by more than 2.6 million women. In general, 92.9% of women who used prenatal care or were entitled for PMTCT services in labor and delivery were advised, and 82.8% of those advised accepted testing. Among women documented as HIV positive, 75.0% got antiretroviral prophylaxis (most of them received a single dose of Nevirapine), and 45.6% of their infants. The most notable changes were maternal HIV testing and receipt of aniretroviral prophylaxis .HIV testing increased from 68.3% in 2000 to 84.9% in 2006 and antiretroviral therapy from 55.7% in 2000 to 79.6% in 2006.(Spensley et al., 2009) Ethical Considerations The nurse must consider the cultural and social cotext and values of the planed location in order to locate the research within the suitable ethical frame work before engaing in global studies (Harrowing et al., 2010).HIV is a disease enclosed by stigmas due to social,cultural and individual differences.It is more pronounced in developing or underdeveloped countries where literacy level is low.This research was mostly done in African countries.Due to colonial history of these places,the intention might have been misinterpreted as trying to impose value and knowledge from the developed world. (Emma Bodén Malmsten, 2009).For minimising the risk of causing harm and violating the integrity of the informant,opt out approach to HIV testing was done.The women had the right to refuse the test without affecting to get the other services. In conclusion, the value of PMTCT programme had gone much beyond the prevention of mother to child transmission. The programme trained the health care providers, enabled laboratory to diagnose HIV, educated and counseled women about HIV, and identified infected individual and educated community members about preventing, transmitting and treating HIV. The foundation's skill has established opt-out testing, providing mothers with drugs when they are diagnosed with HIV and giving the infant dose early have visibly enhanced program effectiveness. PMTCT should be observed as an attainable model and vital part of the range of care and support. It is important to expand the access to PMTCT services in to areas where the services do not exist and to provide more successful regime. Reference Emma Bodén Malmsten, K. O. (2009). The nurse’s professional role in HIV prevention regarding their assignments and perceptions of the profession. Retrieved from http://www.omv.lu.se/uppsatsdb01/updf/2009/2107_2009.pdf Harrowing et al. (2010). Culture, context and community: ethical considerations for global nursing research. International Nursing Review , 70-77. Spensley et al. (2009). Preventing Mother-to-Child Transmission of HIV in Resource-Limited Settings: The Elizabeth Glaser Pediatric AIDS Foundation Experience. American Journal of Public Health , 631-636.