Nurse-initiation and maintenance of patients on antiretroviral therapy: are nurses in primary care clinics initiating ART after attending NIMART training?
OBJECTIVE
To determine the percentage of nurses initiating new HIV-positive patients on therapy within 2 months of attending the Nurse Initiation and Maintenance of Antiretroviral Therapy(NIMART) course, and to identify possible barriers to nurse initiation.


METHODS
A brief telephonic interview using a structured questionnaire of a randomly selected sample (126/1736) of primary care nurses who had attended the NIMART course facilitated by the Foundation for Professional Development (FPD) between October 2010 and 31 March 2011 at primary care clinics in 7 provinces. Outcome measures were the number of nurses initiating ART within 2 months of attending the FPD-facilitated NIMART course.


RESULTS
Of the nurses surveyed, 62% (79/126) had started initiating new adult patients on ART, but only 7% (9/126) were initiating ART in children. The main barrier to initiation was allocation to other tasks in the clinic as a result of staff shortages.


CONCLUSIONS
Despite numerous challenges, many primary care nurses working in the 7 provinces surveyed have taken on the responsibility of sharing the task of initiating HIV-positive patients on ART. The barriers preventing more nurses initiating ART include the shortage of primary care nurses and the lack of sufficient consulting rooms. Expanding clinical mentoring and further training in clinical skills and pharmacology would assist in reaching the target of initiating a further 1.2 million HIV-positive patients on ART by 2012.
University of Pretoria, Pretoria, South Africa. david.cameron@up.ac.za
David
D
Cameron
Amor
A
Gerber
Melusi
M
Mbatha
Judith
J
Mutyabule
Helga
H
Swart
D000328:Adult; D019380:Anti-HIV Agents / Q000627:therapeutic use; D023241:Antiretroviral Therapy, Highly Active / Q000451:nursing; D002648:Child; D005260:Female; D015658:HIV Infections / Q000188:drug therapy* / Q000453:epidemiology / Q000451:nursing*; D006801:Humans; D008297:Male; D055118:Medication Adherence; D008875:Middle Aged; D024802:Nurse's Role; D009726:Nurses / Q000706:statistics & numerical data*; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data; D010347:Patient Care Planning / Q000706:statistics & numerical data*; D011159:Population Surveillance; D057184:Practice Patterns, Nurses' / Q000458:organization & administration*; D011320:Primary Health Care / Q000458:organization & administration*; D013019:South Africa / Q000453:epidemiology; D011795:Surveys and Questionnaires; D013689:Telephone; D055815:Young Adult
D019380:Anti-HIV Agents