HIV Learning Proficiencies Included in the HIV Primary Care Training Platform (Created on January 23, 2013) Foundation
Provider Stage 1
Provider Stage 1 Part 2
Provider Stage 1 Part 2 (cont.)
1.
PART 1
18. Recognize and Manage Immune Reconstitution Syndrome. 19. Identify and Manage Latent TB Infection. 20. Manage Hepatitis B Co-‐Infection. 21. Manage Herpes Simplex (Mucocutaneous) Co-‐Infection. 22. Manage Herpes Zoster Co-‐Infection. 23. Manage Candidiasis (Oral and Esophageal). 24. Manage Bacterial Respiratory Disease. 25. Recognize and Manage Common Gastrointestinal Infections. 26. Treat Common Dermatologic Conditions in HIV patients. 27. Assess and Manage Pain and Peripheral Neuropathy. 28. Screen For and Treat Common STIs: Syphilis, Gonorrhea, Chlamydia, and Genital Herpes. 29. Assess Substance Use/Abuse. 30. Provide Smoking Cessation Counseling and Care. 31. Identify and Mange Mental Health Co-‐ Morbidities: Anxiety/Panic Disorders, Depression, and Insomnia. 32. Assess Substance Use/Abuse. 33. Assess and Mange or Refer Common Oral Health Complaints.
Provide Preventive Reproductive Health Care to HIV-‐Positive Women
Explain the Natural History of HIV Disease to Patients and Families (HIV 101). Define Current Trends in the Epidemiology of HIV Infection in the United States. Integrate HIV Quality Improvement Measures into Patient Monitoring and Care. Optimize Clinic Management to Address Health Needs of HIV-‐ Positive Patients. Adhere to Principles of Confidentiality and HIPAA Regulations Specific to HIV-‐ Positive Patients. Provide HIV Testing in Accordance with CDC Recommendations and State/Local Regulations. Provide Timely Linkage to Care and Treatment for Newly Diagnosed HIV Patients. Provide Culturally Appropriate Patient Education and Care to HIV-‐Positive Patients. Provide a Supportive Care Environment for HIV-‐Positive Patients. Recognize and Address Common Stigma-‐Associated Barriers Encountered by HIV-‐ Positive Patients. Elicit a “Stigma-‐Free” Sexual History as Part of Comprehensive HIV Risk Assessment. Provide Comprehensive “Prevention with Positives” Education. Assess Eligibility for PrEP According to CDC Criteria
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Perform Baseline History & Physical Examination on Newly Diagnosed HIV-‐Positive Patients. Appropriately Order and Interpret Baseline HIV-‐Related Lab Tests. Appropriately Order and Interpret HLA-‐B*5701 Test. Appropriately Order and Interpret HIV Genotype Test. Provide Appropriate Immunizations. Initiate and Monitor Ol Prophylaxis. Identify Need for and Readiness to Begin ARV Treatment (Includes CDC Staging). Prescribe and Manage First-‐Line Antiretroviral (ARV) Regimens with Consideration of Risk/Benefit, and Appropriateness Individualized for Each Patient. Monitor Disease Progression and Response to ARV Therapy. Manage Side Effects and Adverse Events Associated with ARV Regimen. Identify and Manage ARV Drug-‐Drug Interactions. Identify First-‐Line ARV Treatment Failure. Appropriately Switch ARV Regimens due to Toxicity or Side Effects. Assess/Monitor/Counsel Adherence with Medications, Appointments, and Referrals. Assess and Manage Common Complaints in the HIV-‐Positive Patient. Diagnose and Mange Acute Retroviral Syndrome. Appropriately Treat Occupational and Non-‐Occupational Post-‐ Exposure Prophylaxis.
34. Recognize Special Issues and Care and Treatment Needs of HIV-‐Positive Women Through the Life Cycle. 35. Perform Screening PAP Smear. 36. Appropriately Manage Abnormal PAP Smear Results in HIV-‐Positive Women. 37. Identify and Treat Common Vulvo-‐ Vaginal Infections and Inflammatory Conditions in HIV-‐Infected Women. 38. Recognize and Treat Pelvic Inflammatory Disease in HIV-‐Positive Women. 39. Provide Pre-‐Conception Counseling to HIV-‐Positive Women of Reproductive Age to Identify Reproductive Intentions/Promote Safe Conception. 40. Provide Effective Contraceptive Management/Assess Medical Eligibility for Use of Hormonal Contraceptive Agents in HIV-‐Positive Women. 41. Identify Special Considerations for Antiretroviral Use in HIV-‐Positive Women. 42. Consider Drug-‐Drug Interactions in Selection of Appropriate Hormonal Contraceptive in HIV-‐Positive Women on ART
CONTINUATION -‐ HIV Learning Proficiencies Included in the HIV Training Package (Created on January 23, 2013) Provider Stage 2
Provider Stage 2 (cont.)
Provider Stage 3
1.
Women with HIV
1. Identify and Mange 2nd Line ARV Failure and/or 3-‐Class Resistance. 2. Evaluate and Treat Hepatitis C Co-‐Infection. 3. Provide Appropriate Evaluation and Referral for Anal Dysplasia. 4. Recognize and Treat Mycobacterium Tuberculosis Co-‐Infection. 5. Recognize and Manage Progressive Multifocal Leukoencephalopathy. 6. Identify and Mange HIV-‐Associated Neurocognitive Disorders. 7. Identify and Mange HIV-‐Associated Dementia.
Initiate and Manage 2nd Line Antiretroviral Therapy. Identify and Manage Metabolic Syndrome Related to HIV Disease and Treatment. Prevent, Identify, and Manage Lipodystrophy. Identify and Manage Dyslipidemia. Identify and Manage Coronary Heart Disease. Manage Anemia in the Scope of HIV Infection. Evaluate Renal Disease Related to HIV Infection and Treatment. Monitor Hepatitis C Co-‐ Infection. Manage Pneumocystis Pneumonia. Identify and Mange Kaposi’s Sarcoma. Identify and Mange Mycobacterium Avium Complex. Identify and Mange Toxoplasmosis Infection. Identify and Manage Cryptococcal Disease. Identify and Mange Cytomegalovirus Infection. Identify and Manage Histoplasmosis. Identify and Manage Cryptosporidiosis.
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17. Provide Sexually Transmitted Infection Screening and Treatment Considering Special Needs of HIV-‐Positive Women. 18. Provide or Refer for Appropriate Treatment of Abnormal Pap Smear Results in HIV-‐Positive Women. 19. Provide Counseling on Reproductive Options for HIV-‐Concordant and HIV-‐Serodiscordant Couples. 20. Refer HIV-‐Positive Pregnant Women to High Risk Perinatal Specialist for Obstetric Care/Participate in Co-‐Management. 21. Evaluate and Provide Appropriate Counseling and Routine Primary Care to HIV+ Pregnant Women in Consultation with Perinatal Specialist.
Women with HIV 8. 9.
Assess HIV-‐Positive Pregnant Women to Determine Appropriate Prophylaxis/Treatment and Treat or Refer. Provide Appropriate Follow-‐Up of HIV-‐ Exposed Newborns or Refer.
CONTINUATION -‐ HIV Learning Proficiencies Included in the HIV Training Package (Created on January 23, 2013) LPN/LVN/MA Stage 1
RN Stage 1
RN Stage 1 (cont.)
Women with HIV
1.
15. Assess all Patients for High-‐Risk Behavior Related to HIV Infection and Provide Counseling and/or Referral for HIV Testing 16. Assess HIV-‐Positive Patients for High-‐Risk Behavior and Provide Prevention for Positives Counseling and Refer for STI Testing. 17. Recognize Potential Signs and Symptoms of Acute Retroviral Syndrome and Triage to Appropriate Provider. 18. Provide Education to Patients Regarding Current CDC Guidance on Pre-‐Exposure Prophylaxis for MSM. 19. Provide Education Regarding Women's Health to Support the Primary Care of the HIV-‐Positive Woman. 20. Provide Education and Counseling Regarding Prevention of Mother-‐to-‐Child Transmission
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Understand the Natural History of HIV Disease. 2. Understand the Types of Laboratory Tests Commonly Ordered in the Care of HIV-‐ Positive Patients. 3. Monitor Immunization Status of HIV-‐Positive Patients. 4. Monitor Adherence to Medication in HIV-‐Positive Patients. 5. Integrate HIV Quality Improvement into the Clinical Care of HIV-‐Positive Patients. 6. Adhere to Principles of Confidentiality and HIPAA when Providing Care to HIV-‐Positive Patients. 7. Prevent Transmission of HIV in Patient Care Settings. 8. Provide Culturally Appropriate Care to HIV-‐Positive Patients. 9. Provide a Supportive Care Environment for HIV-‐Positive Patients. 10. Recognize Common Stigma-‐ associated Barriers to Care Faced by HIV-‐Positive Patients. 11. Provide Prevention Messages for HIV-‐Positive Patients.
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Provide Care Coordination Based on Local HIV Care Resources that Include Local, State, and Federal Agencies. Obtain Patient History and Review Patient Records of HIV Patients Entering Clinical Care to Support the Care Team. Provide Patient Education on Laboratory Tests ordered at Baseline and at Specific Intervals to Monitor and Manage HIV Patient Care. Monitor Immunization Status of HIV Patients and Provide Patient Education on Recommended Vaccines and Vaccines to Avoid. Provide Patient and Family Education on Common Symptoms/Complaints, and Medication/Self-‐Management of Co-‐ Morbidities and Co-‐Infections. Provide Patient and Family Education on Primary and Secondary Prevention of Common Opportunistic Infections. Provide Patient Education on Occupational or Non-‐Occupational Post-‐ Exposure Prophylaxis. Provide Patient Education on Prescribed ARV Regimen including Dosing Schedule, Food Restrictions, Potential Side-‐Effects, and Side-‐ Effect Prevention/ Management. Assess/Monitor Adherence with Medications, Appointments, and Referrals and Provide Adherence Counseling. Utilize Motivational Interviewing and Counseling Techniques. Assess Nutritional Status and Provide Appropriate Nutrition Counseling and/or Refer to Nutritionist if Appropriate. Assess and Counsel Patients on the Importance of Smoking Cessation. Conduct Mental Health Assessment, Manage Potential Safety Concerns and Refer to Appropriate Mental Health Professional as Necessary. Obtain Substance Abuse History and Assess Current Use, Conduct Education and Counseling, and Refer Appropriately.