Abstract
Poor knowledge and adherence to point-of-care (POC) HIV testing standards have been reported in rural KwaZulu-Natal (KZN), a high HIV prevalent setting. Improving compliance to HIV testing standards is critical, particularly during the gradual phasing out of lay counsellor providers and the shifting of HIV testing and counselling duties to professional nurses. The main objective of this study was to identify priority areas for development of POC diagnostics curriculum to improve competence and adherence to POC diagnostics quality standards for primary healthcare (PHC) nurses in rural South Africa. Method: PHC clinic stakeholders were invited to participate in a co-creation workshop. Participants were purposely sampled from each of the 11 KwaZulu-Natal Districts. Through the Nominal Group Technique (NGT), participants identified training related challenges concerning delivery of quality point of care diagnostics and ranked them from highest to lowest priority. An importance ranking score (scale 1–5) was calculated for each of the identified challenges. Results: Study participants included three PHC professional nurses, one TB professional nurse, one HIV lay councilor, one TB assistant and three POC diagnostics researchers, aged 23–50. Participants identified ten POC diagnostics related challenges. Amongst the highest ranked challenges were the following:absence of POC testing Curriculum for nurses, absence of training of staff on HIV testing and counselling as lay counsellor providers are gradually being phased out,. absence of Continuous Professional Development opportunities and lack of Staff involvement in POC Management programs. Conclusion: Key stakeholders perceived training of PHC nurses as the highest priority for the delivery of quality POC diagnostic testing at PHC level. We recommend continual collaboration among all POC diagnostics stakeholders in the development of an accessible curriculum to improve providers’ competence and ensure sustainable quality delivery of POC diagnostic services in rural PHC clinics.
Highlights
Point-of-care (POC) diagnostic testing is defined as timely clinical testing performed during patient consultation when the result will be used to take appropriate action, which will lead to an improved health outcome [1]
During this time in primary healthcare (PHC) clinics HIV/AIDS testing was done by lay counselors, who were permanently employed staff sent for training specific to performing HIV/AIDS rapid testing and counselling
The findings of this study demonstrate that identifying of priority areas towards improving the quality of POC diagnostic services has an impact on the achievement of the 90:90:90 goal by 2020, which is a local health priority
Summary
Point-of-care (POC) diagnostic testing is defined as timely clinical testing performed during patient consultation when the result will be used to take appropriate action, which will lead to an improved health outcome [1]. In South Africa an HIV Counselling and Testing (HCT) campaign was first launched in April 2010 During this time in PHC clinics HIV/AIDS testing was done by lay counselors, who were permanently employed staff sent for training specific to performing HIV/AIDS rapid testing and counselling. This is a concern because quality assurance programs, which include regular calibration of instruments, participation to external quality assessment schemes, adherence to standard operating procedures and test operator competency as well as running of internal quality control samples on every test day have been shown to ensure accuracy of POC diagnostic testing [4,5] Factors contributing to this problem include poor access to laboratory infrastructure, training resources and institutions due to clinics being situated in deep rural areas, time constraints and lack of motivation to engage in new interventions [3,6,7]
Sign-in/Register to view highlights & summary 
Published Version (
Free)
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call