Browsing by Author "Solomons, Deborah Judy"

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    Factors influencing the confidence and knowledge of professional nurses prescribing antiretroviral therapy in a rural and urban district in the Western Cape
    (Stellenbosch : Stellenbosch University, 2018-03) Solomons, Deborah Judy; Crowley, Talitha; Van der Merwe, A. S.; Stellenbosch University. Faculty of Medicine and Health Sciences. Dept. of Nursing & Midwifery.
    ENGLISH SUMMARY: Introduction: 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 professional nurses in Human Immunodeficiency Virus (HIV) management in primary healthcare settings. Task shifting from doctors to nurses to prescribe antiretroviral therapy (ART) became essential to ensure that more patients living with HIV are initiated on life-saving ART. Although the shifting of tasks is a timely solution for human resource constraints, the continued success of the approach is dependent on factors such as adequate training and effective support systems. However, there is limited evidence on how these factors influence the confidence and knowledge of nurses who prescribe ART in primary health care settings. Aim: The study aimed to investigate factors influencing the knowledge and confidence of professional nurses in managing patients living with HIV in rural and urban primary health care settings in the Western Cape. Methods: A quantitative research approach was used with an analytical, cross-sectional study design. The researcher, based on the literature and previous instruments, designed a self- completion questionnaire. The questionnaire measured demographic details, influencing factors, HIV management confidence and HIV management knowledge. Approval for the study was obtained from the Health Research Ethics Committee (HREC) of Stellenbosch University, the Department of Health and the City of Cape Town. Seventy-seven participants from 29 healthcare facilities completed the questionnaire. Data was entered into Microsoft Excel by the researcher, imported and analysed with a statistical analysing programme, IBM SPSS (version 23). Descriptive statistics were used to describe the data and appropriate statistical tests were used to test for relationships between variables. Results: The majority of participants had adequate HIV management knowledge and reported to be very confident or experts in the HIV management skills / competencies. With regard to the Factors influencing HIV management knowledge and confidence, the research results revealed that participants trained recently in PULSA PLUS / PACK (3years ago or less) had significantly higher knowledge scores. Regular feedback about clinic and personal performance was associated with higher HIV management knowledge. Participants who received mentoring over a period of two weeks had a higher mean confidence score compared to other periods of mentoring. A higher caseload of HIV-positive patients was also associated with higher knowledge and confidence. Conclusion: The results show that training, mentorship and clinical practice experience are associated with knowledge and confidence. Recommendations include the strengthening of current training and mentoring and ensuring that NIMART-trained nurses are provided with sufficient opportunities for clinical practice.