Term of Award

1998

Degree Name

Master of Science in Nursing

Document Type and Release Option

Thesis (restricted to Georgia Southern)

Committee Chair

Charlene M. Hanson

Committee Member 1

Kaye Herth

Committee Member 2

Elissa Emerson

Committee Member 3

Rebecca Ryan

Abstract

This study evaluates the quality of care provided by nurse practitioners HIVinfected clients in a specialized nursing center in Georgia. Quality of care is evaluated using Donabedians' Structure-Process-Outcome domains as presented in the Unifying Model of Quality Health Care. Structure is evaluated as the nurse practitioners in this clinic providing health care. The interpersonal aspect ofthe process of quality health care is measured by the researcher developed Outpatient Client Satisfaction Survey. The technical aspect ofthe process ofquality health care is measured by the researcher developed Provider Adherence Measurement Tool which measures adherence to current clinical practice guidelines. Reliability and validity information is provided on both tools. The outcome ofthe health care provided is measured by the rate ofpneumocystis carinii pneumonia (PCP).

A literature review is included which describes related studies. The data analysis includes a description ofthe demographics ofthe clients in this clinic, and compares the data to national statistics. The adherence ofthe nurse practitioners care to the current clinical practice guidelines is analyzed against the client characteristics of age, CD4 cell count, education completed, gender, race, income, risk factor and insurance coverage. A favorable statistically significant difference is found: as the clients CD4 cell count decreases, the providers' adherence increases.

The outcome of care is determined by active cases of PCP, of which there are none in this sample. Client satisfaction is measured against the client characteristics of age, CD4 cell count, education completed, gender, income, wait time, race, risk factor, and insurance coverage. A statistically significant difference is found in the satisfaction of the nonwhite clients.

The study is summarized with the conclusion that the nurse practitioners in this clinic are providing quality health care to these HTV-infected clients. The limitations ofthe study are described as well as recommendations for future research. A reference list and the actual data collection tools are also included.

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