How does specialist nursing contribute to HIV service delivery across England?
This study aimed to examine what specialist nursing contributes to HIV service delivery across England and how it could be optimised. A three part multi-method qualitative study was undertaken, involving (1) interviews with 19 stakeholders representing professional or service user groups; (2) interviews with nurse/physician pairs from 21 HIV services; and (3) case studies involving site visits to five services. A framework analysis approach was used to manage and analyse the data. There was substantial variability in specialist nursing roles and the extent of role development. Most hospital-based HIV nurses (13/19) were running nurse-led clinics, primarily for stable patients with almost half (6/13) also managing more complex patients. Role development was supported by non-medical prescribing, a robust governance framework and appropriate workload allocation. The availability and organisation of community HIV nursing provision determined how services supported vulnerable patients to keep them engaged in care. Four service models were identified. The study showed that there is scope for providing a greater proportion of routine care through nurse-led clinics. HIV community nursing can influence health outcomes for vulnerable patients, but provision is variable. With limited financial resources, services may need to decide how to deploy their specialist nurses for best effect.
1 Centre for Health and Social Care Research, Sheffield Hallam University, Sheffield, UK.
Hilary
H
Piercy
2 Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK.
Gill
G
Bell
2 Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK.
Charlie
C
Hughes
2 Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK.
Simone
S
Naylor
2 Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK.
Christine A
CA
Bowman
D003152:Community Health Nursing / Q000379:methods*; D019468:Disease Management; D004739:England; D005260:Female; D015658:HIV Infections / Q000451:nursing* / Q000628:therapy; D006801:Humans; D007407:Interviews as Topic; D024802:Nurse's Role; D009726:Nurses; D057184:Practice Patterns, Nurses'; D011320:Primary Health Care / Q000458:organization & administration*; D036301:Qualitative Research; D013041:Specialties, Nursing; D016526:Workload
HIV care; HIV nursing; community care; service development; specialist nursing
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