Original articles
HIV management by nurse prescribers compared with doctors at a paediatric centre in Gaborone, Botswana
Abstract
Methods. A cross-sectional study was conducted in 2009 at the Botswana-Baylor Children’s Clinical Centre of Excellence (COE), Gaborone, Botswana, comparing the performance of nurse prescribers and physicians caring for HIV-infected paediatric patients. Selected by stratified random sampling, 100 physician and 97 nurse prescriber encounters were retrospectively reviewed for successful documentation of eight separate clinically relevant variables: pill count charted; chief complaint listed; social history updated; disclosure reviewed; physical exam; laboratory testing; World Health Organization (WHO) staging documented; paediatric dosing.
Results. Nurse prescribers and physicians correctly documented 96.0% and 94.9% of the time, respectively. There was a trend towards a higher proportion of social history documentation by the nurses, but no significant difference in any other documentation items.
Conclusions. Our findings support the continued investment in programmes employing properly trained nurses in southern Africa to provide quality care and ART services to HIV-infected children who are stable on therapy. Task shifting remains a promising strategy to scale up and sustain adult and paediatric ART more effectively, particularly where provider shortages threaten ART rollout. Policies guiding ART services in southern Africa should avoid restricting the delivery of crucial services to doctors, especially where their numbers are limited.
Authors' affiliations
Gadzikanani Monyatsi,
Paul C Mullan,
Benjamin R Phelps,
Michael A Tolle,
Edwin M Machine,
Floriza F Gennari,
Jenny Makosky,
Gabriel M Anabwani,
Keywords
Cite this article
Article History
Date published: 2011-12-14
Article Views
Full text views: 7351
Comments on this article
*Read our policy for posting comments here