Demonstrates awareness of the mechanisms of transmission of HIV to a child or young person

Demonstrates an understanding of maintaining optimal health in a child with HIV

Demonstrates an awareness of the main issues to be addressed when a child needs to be tested for HIV

Demonstrates in-depth knowledge on the route of transmission of HIV to a child or young person

Demonstrates an in-depth knowledge of promoting optimal health in a child with HIV

Demonstrates appropriate counselling skills when undertaking pre- and post-HIV test discussions, including giving positive and negative test results, with parents and young people

Develops guidelines for testing children and young peopl

Ensures care pathways are in place for referral of children to be tested for HIV across the clinical network

Demonstrates an awareness of the complex issues of disclosure of diagnosis to children

Demonstrates awareness of children’s understanding of illness at different developmental stages

Supports carers and children throughout the process of disclosing the diagnosis of HIV to a child or young person

Undertakes individual work with the child or young person in understanding their illness; demonstrating in-depth knowledge of child development and the child’s understanding of illness at different developmental stages

Develops care pathways and resources around disclosure of diagnosis to children for carers, children and professionals

Contributes to or undertakes research into children’s understanding of their illness or parents views around disclosure

Demonstrates an awareness of the health needs of children and families with HIV

Provides basic information to families regarding maintaining optimal health

Demonstrates an awareness of the sexual health needs of adolescents with HIV

Demonstrates an in-depth knowledge of the signs and symptoms of a child with HIV becoming unwell

Demonstrates an in-depth knowledge of HIV, pathophysiology, transmission and treatment in children

Educates carers and young people about their condition, how to manage it, the signs of illness and when to seek advice

Provides sexual health information and advice to adolescents with HIV and makes appropriate referrals

Demonstrates an awareness of the young person’s sexual health needs. Refers the young person to adult MDT for support around sexual health issues when necessary. Has an awareness of HIV and Young Persons Network (HYPNET) [1]

Develops health promotion strategies across a clinical network

Establishes referral routes for access to sexual health and family planning services

Develops appropriate adolescent transition services across the network, recognising the need for services for vertically infected young people

Develops appropriate adolescent transition services across the network, recognising the need for services for vertically infected young people

Assesses complex health and well-being needs of HIV-positive children and young people. Develops, monitors and reviews plans of care to meet those needs

Demonstrates an understanding of an MDT, who it involves and how to work within it

Demonstrates an awareness of signs of neurological delay and HIV encephalopathy in children

Understands HIV in adults, also considers carer’s needs

Ensures the MDT is involved in assessing the child’s neurological development

Recognises a deviation from normal childhood development and can work within the MDT to ensure the child’s needs are met

Demonstrates an understanding of the carer’s health needs, encouraging the carer to access appropriate healthcare and can refer the carer to adult services wherever necessary

Utilises links with Lead Centre in Children’s HIV National Network (CHINN) Shared Care Network, referring to PENTA guidelines with treatment queries and also CHIVA policies [2]

Develops policies and protocols as part of the MDT so that patients are assessed on a regular basis and thus ensuring their developmental needs are met

Recognises neurological delay in children as a direct result of HIV, confidently liaises with the family in relation to the effects of the delay on the child’s prognosis and acts as advocate for the family on behalf of the MDT

Demonstrates an in-depth knowledge of HIV treatments in general and so can discuss fully carers own treatment options etc. Can offer initial consultations when carers themselves have not accessed their own healthcare, then refers on to adult services

Has an ongoing relationship with Lead Centre (if not based in one) and demonstrates the knowledge and skills to develop policies for Children’s HIV Association (CHIVA) [3]

Has the ability to autonomously recognise whether the child’s well-being needs are being met and has the knowledge and skills to recognise what the MDT can offer as well as outside agencies

Demonstrates an awareness of the UK vaccination policy

Participates in discussions with the child regarding what care they will receive

Demonstrates a basic level of knowledge of paediatric HIV relevant to the clinical area

Demonstrates an understanding of clinical observations necessary to assess a child’s physical well-being and takes and records observations, recognising any deviations from the norm

Participates in caring for the immunosuppressed child and administering ART

Develops an understanding of immunosuppression and how it affects the body

Plans the assessment of the child’s health and well-being needs and prepares for it to take place

Ensures the child’s vaccination history is accurate and all relevant vaccinations have been administered

Ensures the child has an age-appropriate understanding of the care that will be given and advocates on behalf of the family if they are not appropriately informed

Demonstrates a thorough knowledge of paediatric HIV

Demonstrates a thorough knowledge of baseline investigations required according to local guidelines and/or CHIVA guidelines

Advocates for the child who is immunosuppressed and promotes ART according to PENTA guidelines

Recognises symptoms of immunosuppression in infants, children and adolescents and acts as an initial point of contact if the child is unwell or the parents need advice

Ensures that the child’s involvement in decision-making and consent is dependent on their developmental stage and age; understands the importance of working in partnership with the child and carers. Ensures the clinical areas for child assessment are age appropriate and child friendly

Autonomously advises parents and colleagues on vaccinating children with HIV. Has in-depth knowledge of UK vaccination policy and can advise parents and colleagues on vaccinating children with HIV

Demonstrates expert knowledge of paediatric HIV and utilises that knowledge to set up teaching packages for carers and professionals

Assesses and evaluates on an on-going basis which baseline investigations are needed and implements when required (as part of the MDT)

Interprets results and plans for how severely the child may be affected by immunosuppression. Ensures family has direct access to the clinical area during this time

Demonstrates a family-centred approach and has a knowledge of carer’s ART history to ensure optimal care for the child

Visits families at home and provides insight into the child’s and family’s home environment

Provides extensive information on support agencies for children and their carers and can refer a family to relevant voluntary organisations and other agencies for support

Assesses the child and their carer when ART is failing and works in partnership with the family to understand individual challenges around adherence

Has the developed skill set to discuss different drug combinations with carers who may have concerns about their child commencing specific medications

Autonomously makes recommendations on behalf of the family after a home visit

Works in an advisory capacity when requested to by voluntary organisations to assist in recognising and providing the best support possible to families

Utilises nurse-led services to maintain regular follow-up and support for the family. Understands resistance patterns and ongoing ART combinations that can be used in children

Has an awareness of voluntary organisations that offer specific support to families living with HIV

Recognises the difficulties families face when caring for a child who has long-term developmental delay and refers on to senior colleagues when support is not in place

Puts plans in place to ensure that children and carers are supported in the community by necessary members of the MDT and/or voluntary organisations

Assesses the family’s need for support services in the community at the time of presentation and reviews on a regular basis. Encourages families to link in with voluntary organisations to gain support where necessary

Through care planning with the family offers support to child/young person and carer where the child has neurological developmental delay, physical and/or mental as a result of HIV

Enables the child/young person to discuss drug/alcohol abuse in a safe, confidential setting, puts plans in place to regularly review substance abuse with the child/young person

Respects the confidentiality of the children/young people and their family according to the NMC nursing code of conduct [4]

Demonstrates an understanding of the carer’s health status, works with the family to put care plans into place when the carer requires hospitalisation or is unable to care for the child/young person for any reason

Advocates for the child/young person in situations where the carer will not access health services, either for themselves or for the child/young person

Participates in working with the paediatric HIV MDT. Demonstrates an understanding of the need for coordination between the MDT caring for children and families with HIV

Understands the concept of CHINN for the management of paediatric and perinatal HIV

Participates in discharge planning and makes appropriate referrals

Facilitates MDT meetings. Coordinates the MDT providing care to families with HIV to provide effective communication and liaison

Coordinates the smooth running of HIV family clinics for the care of children with HIV and their HIV-positive parents

Participates in CHINN meetings

Facilitates and coordinates the discharge planning for children with HIV

Participates in case conferences and network meetings

Participates in working with the wider MDT including adult HIV team, social services, voluntary sector and primary care to ensure coordinated care for the children and their families

Runs nurse-led clinics for children with HIV or the follow-up of babies born to women with HIV, in line with local protocols

Leads in identifying nursing referral pathways within own CHINN

Leads in identifying pathways of care across CHINN for paediatric and perinatal care management

Participates in or coordinates network steering groups and facilitates service reviews across network

Gives specialist paediatric and perinatal HIV advice to other workers locally and nationally

Demonstrates an awareness of ART e.g. how it works, the different classes of drugs and indicators that ART is failing

Demonstrates awareness of formulations and preparations of the various ARTs and their correct administration including timing and food restriction for children and young people

Demonstrates an awareness of the PENTA guidelines for starting children on ART

Facilitates the correct administration of ART in specialist and non-specialist settings

Participates in assessment of readiness to start ART and the planning and preparation of the child and family for treatment

Anticipates obstacles to good adherence and identifies culturally appropriate interventions to facilitate adherence

Demonstrates awareness of the main side-effects or toxicities of ART and is able to assist in monitoring children and young people

Demonstrates an awareness of drug interactions with ART and how to access information on drug interactions

Demonstrates in-depth and up-to-date knowledge of ART in children

Demonstrates awareness of pharmacokinetics and metabolism of ART in infants, children and young people. Demonstrates good knowledge of side-effects and drug interactions

Demonstrates an in-depth knowledge of the PENTA guidelines for starting children on ART

Demonstrates an in-depth knowledge of the variety of techniques for administering medications to children depending on the age, developmental stage and preference of the child

Assesses the child’s and family’s readiness to start ART. Formulates a plan of what preparations and interventions need to take place prior to starting therapy.

Anticipates obstacles to good adherence and identifies culturally appropriate interventions to facilitate adherence

Interprets blood test results for treatment outcomes, toxicities, side-effects and therapeutic drug monitoring

Demonstrates a good awareness of the potential drug interactions of ART with other drugs and can access information

Provides accurate and up-to-date information on ART to carers and age and developmentally appropriate information for the child or young person

Demonstrates an extensive knowledge of the factors that may influence adherence to therapy. Regularly assesses and reviews adherence

Demonstrates an in-depth understanding of the mechanisms of developing resistance to ART and its implications

Participates in the multidisciplinary decision-making discussions around starting a child on ART

Advises other nurses and healthcare professionals on the management of ART in children and young people

Demonstrates expertise in managing the care of children and young people on ART

Develops integrated care pathways for starting or switching children on ART for network

Reviews children on ART independently, seeking advice or making referrals when problems are identified

Able to run nurse-led clinics for monitoring children on HIV treatment and management of adherence, pill swallowing, etc

Demonstrates awareness of when children may need to change ART and initiates changes in therapy

Coordinates MDT drug meetings and training to ensure good clinical governance in management of ART in children

Develops tools and information resources for carers, children and professionals on HIV and ART in children