Abstract
BackgroundSince the introduction of nurse-initiated and managed antiretroviral treatment (NIMART) in South Africa in 2010, initiation of antiretroviral therapy (ART) in primary care has become the responsibility of nurses. The continued success of this approach is dependent on factors such as adequate training and effective support systems.ObjectivesThis study aimed to investigate factors influencing the knowledge and confidence of professional nurses in managing patients living with human immunodeficiency virus (HIV) in primary healthcare settings in a rural and urban district in the Western Cape.MethodsA cross-sectional survey was conducted amongst 77 NIMART-trained nurses from 29 healthcare facilities to measure demographic details, influencing factors, HIV management confidence and HIV management knowledge.ResultsThe majority of participants had adequate HIV management knowledge and reported being very confident or expert in the HIV management skills or competencies. Participants trained recently on local guidelines (Practical Approach to Care Kit) (3 years ago or less) had significantly higher knowledge scores. Regular feedback about clinic and personal performance was associated with higher HIV management knowledge. Participants who received NIMART mentoring over a period of 2 weeks had a higher mean confidence score compared to other periods of mentoring. A higher caseload of patients living with HIV was also associated with higher knowledge and confidence.ConclusionTraining, mentorship and clinical practice experience are associated with knowledge and confidence. Recommendations include the strengthening of current training and mentoring and ensuring that NIMART-trained nurses are provided with regular updates and sufficient opportunities for clinical practice.
Highlights
Introduction and backgroundSouth Africa has the largest antiretroviral treatment programme in the world.[1]
This study aimed to investigate factors influencing the knowledge and confidence of professional nurses in managing patients living with human immunodeficiency virus (HIV) in primary healthcare settings in a rural and urban district in the Western Cape
Participants who received nurse-initiated and managed antiretroviral therapy (NIMART) mentoring over a period of 2 weeks had a higher mean confidence score compared to other periods of mentoring
Summary
Introduction and backgroundSouth Africa has the largest antiretroviral treatment programme in the world.[1]. The shifting of tasks is a timely solution for human resource constraints, the continued success of the approach depends on factors such as adequate training and effective support systems.[4] The World Health Organization (WHO) recommends that countries should adopt a methodical approach to coordinated, consistent and competencybased education that is needs-driven and approved. This will ensure that all healthcare workers are equipped with the appropriate competencies to undertake the tasks that they perform.[5]. The continued success of this approach is dependent on factors such as adequate training and effective support systems
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