Page 250 - SAHCS HIVMed Journal Vol 20 No 1 2019

Southern African Journal of HIV Medicine
ISSN: (Online) 2078-6751, (Print) 1608-9693
Page 1 of 7 Original Research

Factors influencing the confidence and knowledge of

nurses prescribing antiretroviral treatment in a rural

and urban district in the Western Cape province

Authors: Background: Since the introduction of nurse-initiated and managed antiretroviral treatment
Deborah J. Solomons 1 (NIMART) in South Africa in 2010, initiation of antiretroviral therapy (ART) in primary care
Anita S. van der Merwe 1
Tonya M. Esterhuizen 2 has become the responsibility of nurses. The continued success of this approach is dependent
Talitha Crowley on factors such as adequate training and effective support systems.
1
Affiliations: Objectives: This study aimed to investigate factors influencing the knowledge and confidence
1 Department of Nursing and of professional nurses in managing patients living with human immunodeficiency virus (HIV)
Midwifery, Faculty of in primary healthcare settings in a rural and urban district in the Western Cape.
Medicine and Health
Sciences, Stellenbosch Methods: A cross-sectional survey was conducted amongst 77 NIMART-trained nurses from
University, Cape Town, 29 healthcare facilities to measure demographic details, influencing factors, HIV management
South Africa
confidence and HIV management knowledge.
2 Division of Epidemiology and Results: The majority of participants had adequate HIV management knowledge and reported
Biostatistics, Department of
Global Health, Faculty of being very confident or expert in the HIV management skills or competencies. Participants
Medicine and Health trained recently on local guidelines (Practical Approach to Care Kit) (3 years ago or less) had
Sciences, Stellenbosch significantly higher knowledge scores. Regular feedback about clinic and personal performance
University, Cape Town, was associated with higher HIV management knowledge. Participants who received NIMART
South Africa
mentoring over a period of 2 weeks had a higher mean confidence score compared to other
Corresponding author: periods of mentoring. A higher caseload of patients living with HIV was also associated with
Talitha Crowley, higher knowledge and confidence.
[email protected]
Conclusion: Training, mentorship and clinical practice experience are associated with
Dates: knowledge and confidence. Recommendations include the strengthening of current training
Received: 13 Oct. 2018 and mentoring and ensuring that NIMART-trained nurses are provided with regular updates
Accepted: 25 Mar. 2019
Published: 02 July 2019 and sufficient opportunities for clinical practice.

How to cite this article: Keywords: HIV; NIMART; Primary Healthcare; Clinics; Nurses.
Solomons DJ, Van der Merwe
AS, Esterhuizen TM,
Crowley T. Factors influencing Introduction and background
the confidence and
knowledge of nurses South Africa has the largest antiretroviral treatment programme in the world. Antiretroviral
1
prescribing antiretroviral
treatment in a rural and treatment guidelines are continuously revised, consequently increasing the threshold for
urban district in the Western antiretroviral therapy (ART) treatment. Because of persistent human resource constraints in
Cape province. S Afr J HIV South Africa, task shifting from doctors to nurses to prescribe ART became essential to ensure
Med. 2019;20(1), a923. that more patients living with human immunodeficiency virus (HIV) are initiated on life-
https://doi.org/10.4102/ 2
sajhivmed.v20i1.923 saving ART. Since the introduction of nurse-initiated and managed antiretroviral therapy
(NIMART) in South Africa in 2010, there has been an increased demand for the training of
Copyright: professional nurses in HIV management in the primary healthcare (PHC) setting. The
© 2019. The Authors. availability of NIMART-trained nurses in PHC clinics has improved the access of patients to
Licensee: AOSIS. This work
is licensed under the HIV treatment. 3
Creative Commons
Attribution License. Although 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
4
effective support systems. The World Health Organization (WHO) recommends that
countries should adopt a methodical approach to coordinated, consistent and competency-
Read online: based education that is needs-driven and approved. This will ensure that all healthcare
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Note: This article is based on a Master of Nursing thesis (Stellenbosch University) (http://hdl.handle.net/10019.1/103738).
http://www.sajhivmed.org.za 243 Open Access