Clinical mentoring to improve quality of care provided at three NIM-ART facilities: A mixed methods study
African Journal of Primary Health Care & Family Medicine
| Field | Value | |
| Title | Clinical mentoring to improve quality of care provided at three NIM-ART facilities: A mixed methods study | |
| Creator | Visser, Chris A. Wolvaardt, Jacqueline E. Cameron, David Marincowitz, Gert J.O. | |
| Description | Background: The South African Department of Health implemented the nurse-initiated management of antiretroviral treatment (NIM-ART) programme as a policy to decentralise services. Increasing access to ART through nurse initiation results in significant consequences.Aim: This study evaluated the quality of care provided, the barriers to the effective rollout of antiretroviral services and the role of a clinical mentor.Setting: The study was conducted at three NIM-ART facilities in South Africa. One clinic provided a high standard of care, one had a high defaulter rate, and at the third clinic, treatment failures were missed, and routine bloods were not collected.Methods: A mixed methods study design was used. Data were collected using patient satisfaction surveys, review of clinical records, facility audits, focus group interviews, field notes and a reflection diary.Results: NIM-ART nurses prescribed rationally and followed antiretroviral guidelines.Mortality rates and loss to follow-up rates were lower than those at the surrounding hospitals, and 91.1% of nurse-monitored patients had an undetectable viral load after a year. The quality of care provided was comparable to doctor-monitored care. The facility audits found recurrent shortages of essential drugs. Patients indicated a high level of satisfaction. Salary challenges,excessive workload, a lack of trained nurses and infrastructural barriers were identified as barriers. On-going mentoring and support by a clinical mentor strengthened each of the facilities, facilitated quality improvement and stimulated health workers to address constraints.Conclusion: Clinical mentors are the key to addressing institutional treatment barriers and ensuring quality of patient care. | |
| Publisher | AOSIS | |
| Date | 2018-06-14 | |
| Identifier | 10.4102/phcfm.v10i1.1579 | |
| Source | African Journal of Primary Health Care & Family Medicine; Vol 10, No 1 (2018); 7 pages 2071-2936 2071-2928 | |
| Language | eng | |
| Relation |
The following web links (URLs) may trigger a file download or direct you to an alternative webpage to gain access to a publication file format of the published article:
https://phcfm.org/index.php/phcfm/article/view/1579/2657
https://phcfm.org/index.php/phcfm/article/view/1579/2656
https://phcfm.org/index.php/phcfm/article/view/1579/2658
https://phcfm.org/index.php/phcfm/article/view/1579/2643
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