Degree Name
Nursing Practice, DNP
Publication Date
4-28-2026
First Advisor
Lisa Drake
Second Advisor
Randi McCoy
Abstract
Medication adherence to antiretroviral therapy is essential for viral suppression and improved outcomes among individuals living with human immunodeficiency virus (HIV). Despite advances in treatment, healthcare providers lack confidence in recognizing medication adherence challenges and implementing appropriate interventions. Evidence suggests that provider education using standardized adherence assessment tools improves adherence monitoring and clinical decision-making. The purpose of this quality improvement project is to evaluate whether an educational intervention and a standardized workflow using the CASE Adherence Index would impact healthcare staff confidence in recognizing HIV medication adherence. Lewin’s Change Theory guided the project through the stages of unfreezing, change, and refreezing to support practice change and sustain implementation. The theoretical framework, the Consolidated Framework for Implementation Research, provided a structured approach to evaluating implementation. A pre–post intervention design was used with a sample of eight staff members over a four-week implementation period. Staff confidence was measured using Susan Grundy’s Confidence Scale (C-Scale) before and after the intervention, while adherence screening practices were guided by the CASE Adherence Index, with structured documentation and referral processes. A paired-samples t-test showed that mean confidence scores increased from pre-intervention (M = 2.8) to post-intervention (M = 4.1), indicating a statistically significant improvement, t(7) = 2.01, p = .01. Screening and referral practices also improved, from 1 to 4 referrals following implementation. These findings suggest that integrating interventional education, standardized adherence assessment tools, and structured documentation processes can enhance staff confidence and strengthen adherence monitoring, contributing to improved quality care at the project site.
Rights Management
This work is licensed under a Creative Commons Attribution-NonCommercial-No Derivative Works 4.0 International License.
Recommended Citation
Nwansi-Iro, Joy, "Quality Improvement Project: Impacting Staff Confidence in Recognizing HIV Medication Adherence" (2026). Doctor of Nursing Practice Projects. 317.
https://arch.astate.edu/dnp-projects/317
