National HIV Nurses Association

Discusses and identifies own role within the overall assessment of patients presenting as unwell

Identifies major signs and symptoms of HIV/AIDS and risks of illness associated with relevant CD4 counts

Demonstrates the ability to carry out a nursing assessment of unwell patients, reports the assessment findings in the appropriate format to senior members of the team in a timely fashion

Demonstrates an ability to offer own insights into the well-being needs and wishes of the patient being assessed and offers own suggestions on the treatment that might be needed

Recognises the more urgent presentations of HIV and associated urgent antiretroviral issues

Monitors individuals during assessment activities for significant change and acts appropriately

Discusses and identifies own role within the overall assessment of patients presenting as unwell and can identify the activities to be undertaken through: telephone assessment; and person-to-person assessment

Assesses the presenting complaint and categorises the following: urgency of the presenting problems; whether the problem is likely to be related to HIV and/or side-effects of ART; and refers accordingly to GP/A&E/HIV/other appropriate professional

Evaluates and records assessment findings according to agreed local/network protocols/pathways and in relation to patients’ wishes and beliefs

Identifies HIV-related emergencies with regard to: urgent or life-threatening signs and symptoms; and toxicities, side-effects or other consequences of ART that require immediate intervention or advice

Monitors and evaluates the implementation of treatment plans and makes changes within agreed local/network protocols/pathways

Develops and implements systems that allow for nurse-led assessment and management of patients presenting as unwell with minor illness by developing protocols and pathways taking into consideration national, network and local policy

Demonstrates advanced knowledge in relation to the particular factors that contribute to the complex nature of HIV triage and has ability to define and advise what may and may not be related to HIV and/or ART

Demonstrates the ability to carry out a comprehensive assessment of unwell patients including: history taking; physical assessment and identification of abnormality; ordering relevant investigations; and interpretation of results

Carries out assessment in line with evidence-based practice, protocols, policies and legislation, monitoring individuals during the assessment and adjusting the approach in accordance with changing evidence

Considers and interprets all the information available using systematic processes of reasoning and makes a differential diagnosis as appropriate and explains outcomes to individuals

Identifies and records treatment plans with clear goals that are appropriate to findings

Monitors and evaluates the implementation of treatment plans and makes changes in light of emerging evidence

Describes own role in relation to the support and management of clinically stable patients

Describes the local/network policy relating to the inclusion/exclusion criteria for stable patients whether on or off antiretroviral therapy

Discusses with patients the pros and cons of accessing Nurse-led stable patient clinics and advise regarding access appropriately according to local protocols

Is aware of the required routine blood appointments for stable patients according to local protocol

Demonstrates an awareness of the needs of patients living with a long term condition and the National service Framework for long Term Conditions [1]

Identifies and describes in depth the relevant local policies for clinically stable patients including telephone and e-mail clinics

Identifies own role within the wider MDT in relation to the provision of clinically stable patient clinics and when to refer to other members of the MDT

Identifies and implements essential aspects of managing stable patients, such as adherence, toxicity management and psychological and sexual health

Interprets HIV surrogate markers and routine bloods results and explains their relevance to the patient and other members of the MDT

Uses supervision effectively in managing own caseload of stable/well patients

Identifies, implements and audits pathways for the development of nurse-led stable patient pre-therapy, on-therapy or off-therapy clinics

Identifies own role within the wider MDT in relation to the provision of stable patient clinics for people with HIV, including when complex health needs arise

Prescribes for own caseload of patients using independent or supplementary prescribing as per local policy

Able to interpret blood investigations for stable patients with complex health needs and acts on them appropriately

Provides advice and supervision to junior staff looking after stable patients and uses supervision appropriately for own clinical caseload

Demonstrates extended skills in relation to physical examination, including history taking, investigation ordering and interpretation

Demonstrates an understanding of own role in managing patients with HIV co-infection and co-morbidities

Demonstrates an understanding of relevant policies and protocols in relation to HIV co-infection and co-morbidities

Demonstrates the knowledge and skill in relation to educating patients about different common co-infections and co-morbidities and healthy lifestyle choices

Demonstrates an understanding of treatment choices open to people with HIV co-infections and co-morbidities

Demonstrates an understanding of HIV co-infection and co-morbidities and relevant policies, guidelines and protocols

Demonstrates an understanding of co-infection and co-morbidity screening and monitoring and can interpret relevant investigations

Demonstrates an understanding of the administration, side-effects and risks associated with treatment of different HIV co-infections and co-morbidities according to local need

Demonstrates an understanding of the wider treatment issues relating to HIV co-infection relating to the use of antiretroviral therapies

Demonstrates relevant skills for administration of treatment for different HIV co-infections/co-morbidities and demonstrates the ability to explain treatment issues, including home administration where local need exists

Demonstrates an in-depth understanding of HIV co-infection and co-morbidities especially where complex issues and situation arise

Establishes, monitors and evaluates pathways and procedures for the development and implementation of nurse-led management and support of HIV co-infection or co-morbidity in conjunction with the wider MDT in line with local policies

Establishes, monitors and evaluates education packages around HIV co-infection and co-morbidity for the wider nursing and MDT

Engages patient’s views on the development of services relating to the management, treatment and support of HIV co-infection and relevant resources

Demonstrates an in-depth understanding of co-infection/co-morbidities screening, monitoring and can interpret relevant results

Demonstrates expert practitioner in the management and support of HIV co-infections or co-morbidities according to local need, including assessment, diagnosis, management, use of antiretroviral therapies and associated risks and interactions and can relay this knowledge to the wider team [2–4]

Demonstrates relevant skills for prescribing and administration of treatment to co-infected/co-morbidity patients and demonstrates the ability to explain treatment outcomes to patients and initiate and support patient self-administration

Is aware and can describe local PEP provision and can describe pathway according to local/network policy

Is aware of national policies and guidelines that influence and inform PEP access and support

Describes own role in the support and management of people accessing PEP

Outlines what blood tests need to be taken and when in relation to PEP

Demonstrates awareness of how staff and patients can access PEP on a 24-hour basis across local and networked services

Is aware of, and can describe in detail, what national policies influence and inform PEP provision and access in the UK [5,6]

Carries out patient assessments in relation to identifying risk of transmission and need to access PEP

Explains the physical and psychological effects for patients needing to access PEP and provide support as necessary

Discusses the risks and side-effects associated with PEP

Discusses the management of toxicities relating to PEP and is able to explain these using appropriate language to support patients needing toxicity management

Provides continuing support and management of PEP including the provision of ART and medications to manage side-effects via PGD as per local protocol

Identifies, agrees, implements and monitors systems for the nurse-led management of PEP patients

Writes and develops local policies, competencies and protocols for the assessment, access and delivery of nurse-led access to PEP

Undertakes a comprehensive risk assessment for different HIV transmission routes and advises on the use of PEP

Provides expert support and management of PEP especially when complex health issues apply

Develops PGDs and/or supports independent prescribing for the nurse-led support of patients accessing PEP

Establishes and clarifies pathways for PEP across departments, organisations and local community services ensuring provision for 24-hour access

Provides and supports education on PEP across stakeholders and patient groups