Megan Coe, Nami Kawakyu, Sarah Gimbel, Baraka Nyakuya, Neema Gabriel, Devotha Leonard, Stella Chale, Felix Masiye, Charles M Banda, Saturini Manangwa, Gustav Moyo, Gabriela Boyle, Fernanda Freistadt, Pamela Kohler
{"title":"护理人员队伍优化研究:坦桑尼亚和赞比亚艾滋病服务提供的多方法评估和流程改进干预。","authors":"Megan Coe, Nami Kawakyu, Sarah Gimbel, Baraka Nyakuya, Neema Gabriel, Devotha Leonard, Stella Chale, Felix Masiye, Charles M Banda, Saturini Manangwa, Gustav Moyo, Gabriela Boyle, Fernanda Freistadt, Pamela Kohler","doi":"10.1097/JNC.0000000000000388","DOIUrl":null,"url":null,"abstract":"<p><strong>Abstract: </strong>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.</p>","PeriodicalId":50263,"journal":{"name":"Janac-Journal of the Association of Nurses in Aids Care","volume":null,"pages":null},"PeriodicalIF":1.6000,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10237310/pdf/","citationCount":"0","resultStr":"{\"title\":\"Nursing Workforce Optimization Study: A Multi-method Evaluation and Process Improvement Intervention for HIV Service Delivery in Tanzania and Zambia.\",\"authors\":\"Megan Coe, Nami Kawakyu, Sarah Gimbel, Baraka Nyakuya, Neema Gabriel, Devotha Leonard, Stella Chale, Felix Masiye, Charles M Banda, Saturini Manangwa, Gustav Moyo, Gabriela Boyle, Fernanda Freistadt, Pamela Kohler\",\"doi\":\"10.1097/JNC.0000000000000388\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Abstract: </strong>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.</p>\",\"PeriodicalId\":50263,\"journal\":{\"name\":\"Janac-Journal of the Association of Nurses in Aids Care\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":1.6000,\"publicationDate\":\"2023-03-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10237310/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Janac-Journal of the Association of Nurses in Aids Care\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1097/JNC.0000000000000388\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2023/2/8 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q2\",\"JCRName\":\"NURSING\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Janac-Journal of the Association of Nurses in Aids Care","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1097/JNC.0000000000000388","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2023/2/8 0:00:00","PubModel":"Epub","JCR":"Q2","JCRName":"NURSING","Score":null,"Total":0}
Nursing Workforce Optimization Study: A Multi-method Evaluation and Process Improvement Intervention for HIV Service Delivery in Tanzania and Zambia.
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.
期刊介绍:
The Journal of the Association of Nurses in AIDS Care (JANAC) is a peer-reviewed, international nursing journal that covers the full spectrum of the global HIV epidemic, focusing on prevention, evidence-based care management, interprofessional clinical care, research, advocacy, policy, education, social determinants of health, epidemiology, and program development. JANAC functions according to the highest standards of ethical publishing practices and offers innovative publication options, including Open Access and prepublication article posting, where the journal can post articles before they are published with an issue.