‘Lifting the invisibility cloak’ on the pivotal role of nurses in hepatitis C (HCV) testing, diagnosis and management – findings from an integrated primary healthcare service for marginalised people in inner Sydney, Australia

Abstract

Objective: We sought to quantify the number of episodes of care made by doctors and nurses to six hepatitis C care milestones at an integrated primary healthcare service for marginalised people in inner Sydney, Australia. Background: While nurses are at the coalface of hepatitis C care, they are not adequately represented in workforce data and therefore are less visible. Methods: We conducted a retrospective audit of clinical database records between 2016 (when direct acting antiviral therapy was introduced in Australia) and 2019 for six hepatitis C care milestones. Results: Results revealed nurses’ essential and increasingly substantial contribution to a broad range of hepatitis C care milestones (hepatitis C polymerase chain reaction testing, hepatitis C antibody testing, hepatitis C treatment assessment, Fibroscan, and sustained virologic response confirmation). Conclusion: Findings demonstrate the utility of nurses in accessing marginalised populations and shine a light on the growing value and substantial contribution of nurses to clinical care in the management and treatment of hepatitis C. Implications for research, policy, and practice: The findings presented here highlight the increasing role and broader scope of practice that nurses play in hepatitis C care. Nursing leadership and governance is critical to improving the visibility of nurses through comprehensive workforce data collection to strengthen the nursing workforce and justify role expansion.