First national guidelines for nurses in HIV/AIDS care unveiled

Advancements in testing and treatments have turned HIV/AIDS into a chronic disease. As a result, nurses are playing an important role in caring for people with the infection across a wider range of practice settings.That’s why the Canadian Association of Nurses in AIDS Care (CANAC) published the country’s first national best practice guidelines for nurses in HIV/AIDS care. The organization unveiled “Caring for clients who are at risk for and living with HIV/AIDS” at its annual conference in Toronto last weekend.The guidelines include 20 recommendations spanning practice issues, education, organizational factors and policy matters. CANAC’s president Scott Harrison says the document fills a gap left by post-secondary schools. “A lot has been written about the science of HIV/AIDS, but it’s mostly nurses that deliver frontline care,” he says. “And yet we find there is a distinct lack of HIV/AIDS education for nurses in their undergraduate programs.”The organization collaborated with several HIV experts on the guidelines over a yearlong period. One of those contributors was Paul Kerston of The Positive Living Society of British Columbia, an agency that empowers persons living with HIV/AIDS. The outreach worker helped review the guidelines, and says they reflect nurses’ roles as experts in both medical and social sciences.He points out that before the 90-page document goes in-depth about the clinical side of HIV nursing care, it covers the social determinants of health. For example, it says nurses should assess whether patients have access to food, shelter, an adequate income, and health care early on. The report then advises nurses on connecting patients to the right resources.After addressing psychosocial issues the guidelines then turn to the clinical side of HIV/AIDS nursing care. They outline the current best treatments available to HIV/AIDS patients, their side effects, drug-to-drug interactions, and what nursing care looks like for people on different regimens. Kerston says advancements in antiretroviral therapies have meant some of his clients who used to take 10 pills per day now take only one.However, he adds that when patients are on three or more medications their care becomes more complex, making the role of nurses even more important. “While they can’t prescribe or dispense, they can administer therapy and give suggestions—in that respect, nurses have a stronger connection with the patient,” he says.The report covers prevention as well, including new tests nurses could put into practice and how to counsel patients pre and post-diagnosis. What’s more, it raises awareness of populations that are overrepresented in Canada’s HIV epidemic, including aboriginals and marginalized communities.Harrison, a registered nurse, says it was important that the guidelines also inform nurses about how they can campaign for HIV/AIDS patients. That's why the report advises nurses on reaching out to policymakers. “A big part of our role in Canada is to advocate for not only the best possible care and treatments available, but also for the rights and dignity of people living with the disease,” he says.The authors spoke with HIV/AIDS patients from across the country about their experiences with nurses when developing the guidelines. They then developed clinical vignettes based on that feedback, which are included throughout the report. “It helped us illustrate the guidelines in a much more human way,” says Harrison. “We wanted them to be a living document that actually helped people change their practice, rather than something that ends up gathering dust on shelves.”Kerston says the examples make the guidelines compelling. “When you have these cases it makes it real, and these case studies are very real.”The outreach worker describes nurses as implementers and educators for people with HIV/AIDS. When patients are unclear about something, nurses are there to educate them. When patients receive a care plan, nurses act on it. When they need the services of other healthcare providers, nurses are the ones who connect them with the right practitioner. “Somebody has to initiate action, and that is nurses,” he says.Download a copy of the guidelines here or visit www.canac.org.

First national guidelines for nurses in HIV/AIDS care unveiled

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