Integrating HIV-Related Evidence-Based Renal Care Guidelines Into Adult HIV Clinics

The purpose of this evidence-based practice (EBP) project was to implement research-based, clinic-specific renal care guidelines into two adult HIV clinics. The two main components of the project included (a) implementation of clinic-specific renal care guidelines and (b) initiation of renal and general health patient education by clinic support staff. Overall, statistically significant improvement was shown postguideline implementation in proportion of urinalyses (UA) (p=.01) and estimated glomerular filtration rates (eGFR) (p=.002) completion for patients during initial clinic visits and for those requiring yearly (UA p < .001, eGFR p < .001) or twice-yearly (UA p < .001, eGFR p < .001) renal testing. The rate of renal health education provided to patients by nurses was 60.7%. Results suggest that advanced practice nurse-led EBP change implementation can result in better renal care in outpatient HIV care settings. The process described could be used to implement EBP in other clinic sites.

Key words: chronic kidney disease, evidence-based practice, HIV