Hanrahan Barbara A, Williams Adri
Department of Nursing, University of the Witwatersrand, South Africa.
Edupark, Polokwane, South Africa.
South Afr J HIV Med. 2017 Jun 28;18(1):690. doi: 10.4102/sajhivmed.v18i1.690. eCollection 2017.
When new guidelines for existing programmes are introduced, it is often the clinicians tasked with the execution of the guidelines who bear the brunt of the changes. Frequently their opinions are not sought. In this study, the researcher interviewed registered nurses working in the field of the prevention of mother-to-child transmission (PMTCT) of human immunodeficiency virus (HIV) to gain an understanding of their perspectives on the changes introduced to the guidelines. The guideline changes in 2014 were to move from the World Health Organization (WHO) Option B to Option B + which prescribes lifelong antiretroviral therapy (ART) for all HIV-positive pregnant women regardless of CD4 cell count.
To determine what the registered nurses' perspectives are on the PMTCT programme as implemented at four PHC facilities in the Limpopo Province.
For this qualitative investigation, a descriptive research design was implemented. The data were collected during semi-structured interviews with nurses from four primary healthcare facilities in the Limpopo Province of South Africa. Data were analysed using thematic analysis.
Challenges preventing effective implementation (e.g. increased workloads, viz. staff shortages; poor planning of training; equipment and medication shortages and long lead times; poor patient education) were identified.
In spite of the successes of the PMTCT programme, considerable challenges still prevail; lack of patient education, poor facilities management and staff shortages could potentially influence the implementation of the PMTCT guidelines negatively.
当现有项目引入新指南时，负责执行指南的临床医生往往首当其冲受到变革的影响。他们的意见常常未被征求。在本研究中，研究人员采访了在预防人类免疫缺陷病毒（HIV）母婴传播（PMTCT）领域工作的注册护士，以了解他们对指南所做变更的看法。2014年指南的变更内容是从世界卫生组织（WHO）的B方案转变为B +方案，即无论CD4细胞计数如何，都要为所有HIV阳性孕妇提供终身抗逆转录病毒治疗（ART）。
确定在林波波省四个初级卫生保健机构实施的PMTCT项目中，注册护士的看法是什么。
对于这项定性调查，采用了描述性研究设计。数据收集于对南非林波波省四个初级卫生保健机构护士的半结构化访谈期间。使用主题分析法对数据进行分析。
确定了阻碍有效实施的挑战（例如工作量增加，即人员短缺；培训规划不佳；设备和药品短缺以及交货时间长；患者教育不足）。
尽管PMTCT项目取得了成功，但仍然存在相当大的挑战；患者教育不足、设施管理不善和人员短缺可能会对PMTCT指南的实施产生负面影响。
