Nursing Workforce Optimization Study: A Multi-method Evaluation and Process Improvement Intervention for HIV Service Delivery in Tanzania and Zambia.

Autor:	Coe M; Megan Coe, MSN, RN, is a Doctoral Student, Department of Child, Family, and Population Health, School of Nursing, University of Washington, Seattle, Washington, USA. Nami Kawakyu, PhD, MPH, RN, is a Research Analyst, Department of Global Health, University of Washington, Seattle, Washington, USA. Sarah Gimbel, PhD, MPH, RN, is a Professor, Department of Global Health, and the Department of Child, Family, and Population Health, School of Nursing, University of Washington, Seattle, Washington, USA. Baraka Nyakuya, MD, is a Technical Advisor, International Training and Education Center for Health (I-TECH), Dar es Salaam, Tanzania. Neema Gabriel, MSW, is a Program Manager, International Training and Education Center for Health (I-TECH), Dar es Salaam, Tanzania. Devotha Leonard, MPH, RN, is a Field Epidemiology Training Program Training Coordinator, International Training and Education Center for Health (I-TECH), Dar es Salaam, Tanzania. Stella Chale, MD, is the Country Representative, International Training and Education Center for Health (I-TECH), Dar es Salaam, Tanzania. Felix Masiye, PhD, MSc, is the Dean of the School of Humanities and Social Sciences, University of Zambia, Lusaka, Zambia and an Affiliate Assistant Professor at the Institute for Health Metrics and Evaluation (IHME), University of Washington, Seattle, Washington, USA. Charles Masili Banda, MA, BA, is a Lecturer, Department of Economics, School of Humanities and Social Sciences, University of Zambia, Lusaka, Zambia. Saturini Manangwa, MSc (Tropical Disease), RN, is an Assistant Director for Nursing and Midwifery Quality Improvement, Ministry of Health Community Development, Gender, Elderly and Children (MOHCDGEC), Dodoma, Tanzania. Gustav Moyo, MA, RN, is the Director of Nursing and Midwifery Services, Ministry of Health, Community Development, Gender, Elderly and Children (MOHCDGEC), Dodoma, Tanzania. Gabriela Boyle, MPH, RN, is a Monitoring and Evaluation Advisor, I-TECH, Department of Global Health, University of Washington, Seattle, Washington, USA. Fernanda Freistadt, MPH, is a Senior Program Manager, I-TECH, Department of Global Health, University of Washington, Seattle, Washington, USA. Pamela Kohler, PhD, MPH, RN, is an Associate Professor, Department of Global Health, and the Department of Child, Family, and Population Health, School of Nursing, University of Washington, Seattle, Washington, USA., Kawakyu N, Gimbel S, Nyakuya B, Gabriel N, Leonard D, Chale S, Masiye F, Banda CM, Manangwa S, Moyo G, Boyle G, Freistadt F, Kohler P
Jazyk:	angličtina
Zdroj:	The Journal of the Association of Nurses in AIDS Care : JANAC [J Assoc Nurses AIDS Care] 2023 Mar-Apr 01; Vol. 34 (2), pp. 146-157. Date of Electronic Publication: 2023 Feb 08.
DOI:	10.1097/JNC.0000000000000388
Abstrakt:	Abstract: Nurses are often suboptimally used in HIV care, due to misalignment of training and practice, workflow inefficiencies, and management challenges. We sought to understand nursing workforce capacity and support implementation of process improvement strategies to improve efficiency of HIV service delivery in Tanzania and Zambia. We conducted time and motion observations and task analyses at 16 facilities followed by process improvement workshops. On average, each nurse cared for 45 clients per day in Tanzania and 29 in Zambia. Administrative tasks and documentation occupied large proportions of nurse time. Self-reported competency was low at baseline and higher at follow-up for identifying and managing treatment failure and prescribing antiretroviral therapy. After workshops, facilities changed care processes, provided additional training and mentorship, and changed staffing and supervision. Efficiency outcomes were stable despite staffing increases. Collaborative approaches to use workforce data to engage providers in improvement strategies can support roll-out of nurse-managed HIV treatment. (Copyright © 2023 Association of Nurses in AIDS Care.)
Databáze:	MEDLINE
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