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Abstract number WEPDD0103

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Abstract number WEPDD0103

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  1. Clinical Mentorship of Nurse-Initiated Antiretroviral Therapy in Khayelitsha, South Africa: A Quality of Care Assessment Ann Green1*; Virginia de Azevedo2; Gabriela Patten, 3; Mary-Ann Davies4; Mary Ibeto3; Vivian Cox31University of Cape Town School of Public Health and Family Medicine2City of Cape Town Department of Health 3Médecins Sans Frontières Khayelitsha4University of Cape Town Centre for Infectious Disease Epidemiology and Research*Now with the Vanderbilt Institute for Global Health, Nashville, TN, USA Abstract number WEPDD0103

  2. Methods Before-after study (February 2011 – September 2012) • 229 patient folders reviewed to assess: • Number of patients initiated on ART by nurses • Patient characteristics: doctor and nurse initiations • Quality measures • Quality of ART initiations • Quality of ART management before & after mentorship • Selfadministered questionnaires: nurse confidence to initiate and manage ART

  3. Results • 21 nurses authorized by 1 nurse mentor • 77% of eligible patients initiated by nurses • Majority of clinical indicators recorded at ART initiation successfully completed by nurses • Doctors initiated more TB/HIV co-infected patients & WHO stage 3 or 4 disease than nurses • Improvements in ART management: • drawing required bloods (91% vs 99%, p=0.03), • WHO staging (63% vs 91%, p<0.001), • assessing adherence (50% vs 78%, p<0.001) • Nurse confidence improved for NIMART

  4. Conclusions • Nurse mentorship programme feasibility • Mentorship can ensure quality nurse-led HIV care & treatment, improve nurse confidence • Nurses can initiate majority of eligible patients, medical officers free to manage complex cases • Nurses continue to initiate patients after mentorship • Successful pilot translating NIMART policy into practice

  5. Acknowledgements • Dr. Vivian Cox, MSF • Dr. Mary-Ann Davies, UCT • Gem Patten, MPH, MSF • Dr. Mary Ibeto, MSF • Nikiwe Mkhosana • Nombulelo Raphahlelo • Khayelitsha City Clinics staff • NIMART nurses

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