Chamane Nkosinothando, Kuupiel Desmond, Mashamba-Thompson Tivani Phosa
Department of Public Health Medicine, School of Nursing and Public Health, University of KwaZulu-Natal, Durban 4041, South Africa.
Department of Public Health, University of Limpopo, Polokwane 0723, South Africa.
Diagnostics (Basel). 2020 Apr 1;10(4):195. doi: 10.3390/diagnostics10040195.
UNLABELLED: Poor knowledge and adherence to point-of-care (POC) HIV testing standards have been reported in rural KwaZulu-Natal (KZN), a high HIV prevalent setting. Improving compliance to HIV testing standards is critical, particularly during the gradual phasing out of lay counsellor providers and the shifting of HIV testing and counselling duties to professional nurses. The main objective of this study was to identify priority areas for development of POC diagnostics curriculum to improve competence and adherence to POC diagnostics quality standards for primary healthcare (PHC) nurses in rural South Africa. METHOD: PHC clinic stakeholders were invited to participate in a co-creation workshop. Participants were purposely sampled from each of the 11 KwaZulu-Natal Districts. Through the Nominal Group Technique (NGT), participants identified training related challenges concerning delivery of quality point of care diagnostics and ranked them from highest to lowest priority. An importance ranking score (scale 1-5) was calculated for each of the identified challenges. RESULTS: Study participants included three PHC professional nurses, one TB professional nurse, one HIV lay councilor, one TB assistant and three POC diagnostics researchers, aged 23-50. Participants identified ten POC diagnostics related challenges. Amongst the highest ranked challenges were the following:absence of POC testing Curriculum for nurses, absence of training of staff on HIV testing and counselling as lay counsellor providers are gradually being phased out,. absence of Continuous Professional Development opportunities and lack of Staff involvement in POC Management programs. CONCLUSION: Key stakeholders perceived training of PHC nurses as the highest priority for the delivery of quality POC diagnostic testing at PHC level. We recommend continual collaboration among all POC diagnostics stakeholders in the development of an accessible curriculum to improve providers' competence and ensure sustainable quality delivery of POC diagnostic services in rural PHC clinics.
未标注：据报道，在艾滋病毒高流行地区夸祖鲁-纳塔尔省农村地区，对即时检验（POC）艾滋病毒检测标准的了解和遵守情况较差。提高对艾滋病毒检测标准的依从性至关重要，尤其是在逐步淘汰非专业咨询员并将艾滋病毒检测和咨询职责转移给专业护士的过程中。本研究的主要目的是确定即时检验诊断课程开发的优先领域，以提高南非农村地区初级卫生保健（PHC）护士对即时检验诊断质量标准的能力和依从性。 方法：邀请初级卫生保健诊所的利益相关者参加共创研讨会。参与者从夸祖鲁-纳塔尔省的11个区中特意抽取。通过名义小组技术（NGT），参与者确定了与提供高质量即时检验诊断相关的培训挑战，并将其按优先顺序从高到低进行排序。为每个确定的挑战计算重要性排名分数（1-5分制）。 结果：研究参与者包括3名初级卫生保健专业护士、1名结核病专业护士、1名艾滋病毒非专业咨询员、1名结核病助理和3名即时检验诊断研究人员，年龄在23至50岁之间。参与者确定了10个与即时检验诊断相关的挑战。排名最高的挑战包括：护士缺乏即时检验课程，随着非专业咨询员逐渐被淘汰，工作人员缺乏艾滋病毒检测和咨询培训，缺乏持续专业发展机会以及工作人员未参与即时检验管理项目。 结论：关键利益相关者认为，培训初级卫生保健护士是在初级卫生保健层面提供高质量即时检验诊断的最高优先事项。我们建议所有即时检验诊断利益相关者持续合作，开发一门易于获取的课程，以提高提供者的能力，并确保农村初级卫生保健诊所可持续地提供高质量即时检验诊断服务。
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