National HIV Nurses Association

Demonstrates an understanding of how ART works, drug classes, administration, times, dietary restrictions and key side-effects

Demonstrates an understanding of relevant policies and protocols that relate to the provision of ART

Recognises common side-effects, particularly those requiring urgent attention and has awareness that these may be similar to HIV disease manifestations

Demonstrates awareness of the occurrence of drug interactions and knows how to access advice about interactions

Demonstrates an awareness of ART-related blood tests and other relevant investigations, such as urinalysis, according to national and local protocols

Demonstrates how to access help and advice on HIV treatments, their outcomes and side-effects

Recognises when situations are detrimental to the correct administration of ART, such as nausea and vomiting and hospitalisation

Facilitates correct administration of ART in specialist and non-specialist settings, including self-administration of medications according to local policies

Reports to the HIV-specialist nurse, pharmacist or doctor if there are any difficulties with ART administration

Asks appropriate questions about adherence in relation to local adherence protocol and with regard to evidence base for health beliefs and other factors that influence adherence

Identifies potential and actual problems with adherence

Explains treatments to patients in a manner relevant to the patient's own knowledge and understanding

Identifies the information needs of patients in relation to ART

Identifies how to access help for patients if they experience problems with ART both within and outside working hours

Supports the administration and assessment of treatment regimens according to local protocols and policies and in conjunction with relevant members of the MDT

Demonstrates an understanding of the physical and psychological needs of patients presenting with long-term side-effects and where to refer patients who need support

Demonstrates the ability to recognise long-term side-effects of ART, such as lipoatrophy, lipodystrophy, raised lipids, cardiovascular disease risk factors, renal and liver dysfunction, metabolic and osteopenic disorders

Demonstrates awareness of current clinical trials in ART and how patients can access clinical trials within a service network

Demonstrates an in-depth and up-to-date knowledge of ART and mechanisms of different classes of antiretroviral drugs

Demonstrates an in-depth knowledge of administration of ART including times, dietary restrictions, side-effects, adherence assessments and resistance

Demonstrates knowledge of key drug interactions and how to access advice for nurses and patients on drug interactions

Demonstrates ability to order tests for surrogate markers, ART-related toxicities and routine monitoring tests according to local protocol

Interprets blood results for treatment outcomes, toxicities and side-effects

Applies the principles of adherence to therapy and describes the nurse's role in assessing and promoting adherence [2]

Correctly administers or advises patients on administration of ART and advises other nurses on management of and adherence to ART

Anticipates any threats to ART administration in the inpatient and outpatient setting and intervenes to facilitate optimal adherence

Assesses effective adherence and asks in-depth questions about adherence and correct administration of medications

Assesses and triages problems associated with medications and side-effects, including short- and long-term side-effects

Assesses patient information needs and develops plan of care to address these needs

Has ability to identify challenges to adherence and plan culturally and socially appropriate interventions with patients to address their adherence issues

Able to implement and advise on self-medication programmes

Able to assess the physical and psychological needs of patients presenting with long-term side-effects and formulate a plan of care to address those needs

Proactively assesses for long-term side-effects of ART and takes action to maximise prevention and monitoring of long-term side-effects (as listed) where possible, incorporating this into nurse-led clinics and patient group directions (PGDs) where appropriate

Refers to medical and other healthcare professionals where long term side-effects require further specialist advise and intervention according to local protocols

Refers for therapeutic interventions for facial lipoatrophy, such as poly-lactic acid and/or administers therapeutic interventions according to local protocols including PGDs where appropriate

Supports patients who are considering clinical trials and acts as a patient advocate, liaising with clinical trial teams as required

Demonstrates advanced expertise in managing patients on ART in line with local policies and national policies [1]

Identifies when changes to ART may be indicated and works with MDT to suggest appropriate changes

Demonstrates in-depth knowledge of drug interactions and applies to nurse-led activities

Establishes nurse-led clinics for monitoring patients on therapy

Cares for patients on ART autonomously and in partnership within the wider MDT

Prescribes of approved medications within the scope of supplementary or independent non-medical prescribing according to local and national protocols

Establishes and monitors systems in place to ensure correct ART administration for patients across services and when having clinical procedures

Establishes effective systems of adherence-assessment monitoring in conjunction with medical and pharmacy teams

Establishes clear patient referral pathways to allied health professionals, relevant inpatient and outpatient departments and HIV community-based organisations

Promotes and/or facilitates inpatient self-medication programmes according to local policies

Ensures appropriate pathways are in place for referral to allied specialists with regard to long-term side-effects

Establishes systems for proactive assessment, monitoring and treatment of long-term side-effects (as listed) within nurse-led services as agreed locally

Demonstrates ability to address the long-term side-effects of ART within complex situations and where co-infections and co-morbidities exist

Establishes systems for prevention of long-term side-effects where possible, such as smoking cessation, dietary and exercise interventions

Ensures systems, policies and procedures are in place to deliver therapeutic interventions for lipoatrophy under PGD or appropriate guidelines