NURSING 

OVERVIEW 

A 2010 audit of the undergraduate curriculum of the Bachelor of Nursing curriculum revealed many gaps relating to the integration of HIV, including a disjointed HIV/AIDS content which was not aligned to the different levels of learning outcomes for the year of study and various academic staff requiring updates on HIV content and new developments in HIV and AIDS care.

During this audit the South African government identified the Nurse Initiated Management of Antiretroviral Therapy (NIMART) as a key strategy for expanding access to HIV treatment at PHC level, highlighting the need to offer training in NIMART as part of the undergraduate program.

MEPI SUPPORT

MEPI support was used to revise the curriculum to bridge these gaps and ensure the integration of HIV education as  a golden thread across the 4 years. The management in the School of Nursing and Public Health wanted the staff to be adequately skilled to teach students to ensure revised changes are sustainable and that a clinical skills laboratory would be developed to support both the theoretical and practical HIV education offered to the students. 

• HIV case studies in General Nursing, Community Health Nursing, Midwifery and Mental Health Nursing, appropriate for the level learning outcomes from first to fourth year were developed by a team of nursing experts in 2011 in consultation with a clinical and academic mentor from the MEPI-UKZN partner school, CU. The case studies were implemented, and later revised in 2013 to ensure continued relevance to health care policies and HIV care plans.
• An annual 5-day HIV Counselling and Adherence workshop to develop counselling skills and adherence was introduced to around 60 – 70 second year community health undergraduates together with our CU partner in 2011. The skills related to HIV care and treatment. Didactic lectures, role modelling, games and quizzes were used as part of the training.
• NIMART is a 5 day National Department of Health accredited training program aimed at capacitating nurses with key skills needed to initiate HIV patients on antiretroviral therapy (ART).  Led by ECI, facilitators run NIMART trainings for both 4th year undergraduate nursing students as well as practicing registered nurses doing post-basic programs like Advanced Midwifery and PHC. Around 350 students are trained annually through support from MEPI and to date a total of 1195 preservice and in-service nurses has been trained in NIMART. The scheduled evaluations of all cohort trainings has consistently shown significant increase in knowledge in ART management from baselines.
• A total of 20 clinical competencies specifically focusing on HIV/AIDS has been developed by the MEPI-employed nursing clinical mentor aimed at equipping students with specialized skills required in care viz the correct technique for HIV testing in adults and children counselling the individual, care giver, couples, etc.
• HIV morning sessions which includes lectures on current HIV issues, group discussions on myths and barriers, clinical skills demonstration and the use of electronic and visual media, were introduced by the clinical mentor in 2012. These twice weekly sessions provide students with the opportunity to master skills in HIV treatment and care under the supervision of an experienced mentor.