National HIV Nurses Association

Demonstrates an understanding of own role in relation to the management of inpatients with HIV-related conditions

Demonstrates an understanding of the main HIV-related conditions precipitating inpatient care

Demonstrates a knowledge of the relevant local policies and protocols for the treatment and management of HIV-related conditions

Assists in the management of the critically ill patient

Demonstrates an awareness of the current national BHIVA guidelines and their relevance to inpatient care

Demonstrates an awareness of the potential rapidity of deterioration of patients with an HIV-related condition

Carries out the observations required for early detection of changes as per local protocol e.g. local early warning scores

Records and reports any deterioration promptly to the appropriate members of the care team

Able to explain to the patient the purpose of regular assessment of their condition and encourage self-reporting

Is aware of the potential needs of a patient receiving an HIV-positive diagnosis as an inpatient

Is aware of the potential impact for patients in the transition from chronic HIV infection to an acute illness

Demonstrates an awareness of the conditions, signs and symptoms that require either source or protective isolation

Demonstrates awareness of the potential risks to a patient who requires isolation e.g. risk of falls, deterioration, etc

Demonstrates an understanding of the potential effects of isolation on the psychological and social well-being of the patient

Demonstrates awareness of the potential effect of repeat admissions on a patient’s well-being

Demonstrates awareness of the differing needs of patients requiring rehabilitation

Demonstrates an understanding of the discharge process and local policies, guidelines and assessment tools to aid discharge planning, including case conferences and home visits

Demonstrates awareness of the support services statutory and voluntary available to patients on discharge

Documents and reports to the MDT any changes that may affect discharge plans

Assists the patient to articulate their needs on discharge

Demonstrates an understanding of the decision to change from acute intervention to palliation as directed by the care team in partnership with the patient and/or significant others

Is aware of advanced directives and their role in HIV care

Supports and assists the patient to understand the nature of their condition and its impact on their health and well-being

Understands the relevant policies and protocols for the management and treatment of acute HIV-related conditions and is able to inform, support and involve patients in the planning of their care

Under supervision, provides one-to-one care of the critically ill, level one, patient including non-invasive ventilation

Plans the appropriate level of assessment and observation, in conjunction with the medical team, to ensure early detection of any changes

Records and interprets findings reporting to appropriate team members as per protocol

Ensures adequate social, psychological and spiritual support for patients facing acute illness and/or a new HIV-positive diagnosis

Assesses the need for isolation on all admissions as per local protocol

Assesses and mitigates the risk of caring for patients in isolation

Provides practical and psychological support for the patient to self manage the experience of isolation

Manages the potential effects of repeat admissions on the patent’s well-being and ensures continuity of care

Identifies, manages and refers, if required, the patient who has rehabilitation needs

Ensures discharge planning commences on admission, setting an expected date of discharge in conjunction with the medical team

Assesses plans and evaluates in partnership with the patient and their significant others, as appropriate, a comprehensive discharge package ensuring involvement of the relevant MDT members

Assesses the safety issues prior to discharge of the chronically ill/disabled patient

Supports patient within the case conference acting as their advocate as required

Supports a patient in the transition from acute to palliative care

Able to inform a patient regarding end-of-life decisions including advanced directives, wills etc.

Ensures there is appropriate education and mentoring in the principles of managing inpatients with HIV-related conditions

Contributes to the development of guidelines and competencies for the nurse management of HIV-related conditions

Supports and supervises junior staff including medical staff to manage the critically ill patient

Is able to support staff in assessing acutely sick patients

Leads on the development of a multidisciplinary approach to the management of the newly diagnosed HIV patients admitted with an acute HIV-related condition

Supports staff in understanding the needs of patients with a new HIV-positive diagnosis or a new acute HIV-related condition

Develops cross-working with infection control and a regular review of policies in relation to the management of HIV-related conditions

Ensures the policies for isolation are understood and implemented by staff, patients and visitors

Develops systems of care delivery to ensure continuity of care for patients on each subsequent admission e.g. primary/team nursing, caseload management

Ensures MDT collaboration between primary, acute and rehabilitation care to assist in safe discharge

Develops MDT structures to enable regular review of patient care and preparation for discharge

Discusses end-of-life decisions with patients and their significant others

Is aware of the principles of symptom control

Is aware of the four main symptoms: pain; nausea and vomiting; fevers; and diarrhoea, which may affect patients with HIV, with HIV-related conditions, in the end stages of life or those on ART

Understands the assessment and general management of symptoms as per local guidelines

Assists in the assessment, recording and reporting of symptoms using evidence-based assessment tools such as pain assessment tools, stool charts, etc

Supports and encourages the patient to describe and report symptoms and self-record

Assists in the evaluation of the effectiveness of treatment and reporting findings to the relevant team member

Understands the principles of symptom control

Understands the aetiology, manifestation, management and treatment of the main symptoms in HIV/AIDS

Assesses, plans and evaluates symptom management in partnership with the patient

Refers appropriately to the relevant MDT members

Supports patients’ psychological well-being during the period of treatment induction for symptom control

Evaluates the efficacy of treatment and reports to the care team as required

Develops education to assist nurses to develop the planning, assessment and evaluation skills in symptom control

Collaborates with the MDT in the development and/or evaluation of tools and protocols to assist in the management of symptoms

Develops symptom control information tailored to the needs of the patient as required

Demonstrates and maintains an in-depth knowledge of developments and changes in symptom control

Demonstrates an understanding and awareness of the issue of confidentiality as related to stigma and HIV

Assists in assessing and recording the patient’s nominated next of kin, social network and level of disclosure to significant others

Ensures the MDT members are aware of the patient’s confidentiality needs

Assists significant others to understand confidentiality

Demonstrates an awareness of patient choice and its implications for the role of the care team in service provision

Demonstrates an understanding of the importance of the patients’ wishes regarding the involvement of significant others in their care

Demonstrates an understanding of their role as an advocate

Assesses the patient’s social network, level of disclosure and potential or actual issues regarding the nominated next-of-kin

Supports patients in making informed decisions regarding disclosure

Refers the patient to the relevant MDT members regarding disclosure issues

Supports the patient’s significant others to understand patient choice and acts as advocate to ensure that the patient’s wishes are upheld

Provides appropriate support and information for patients’ significant others

Ensures there are policies and procedures in place to protect confidentiality in all areas of activity in the ward environment

Manages complex issues related to disclosure and/or problems within the patient’s social network

Alerts the team to any potential risks for the patient in the context of their significant others e.g. protection of the vulnerable adult (POVA) [1]

Develops structures to enable support of significant others