Clarification and evaluation of specialist and advanced nurisng roles - a critical review and case study of the HIV clinical nurse specialist
Totterdell, Rachel (2009) Clarification and evaluation of specialist and advanced nurisng roles - a critical review and case study of the HIV clinical nurse specialist. [Dissertation (University of Nottingham only)] (Unpublished)
Over the past 20 years, specialist and advanced roles have developed in all areas of nursing. The scope of practice for these roles is often ambiguous, with few clear guidelines and definitions. Having clarity in these roles is vital for role effectiveness and optimising patient care. This critical review examines one such role, that of the HIV Clinical Nurse Specialist (CNS). HIV is a relatively new disease and its treatment has changed significantly since its identification in the early 1980s. The history of the disease is described and the changes in its treatment, including the revolution in HIV nursing care as a result of highly active anti-retroviral treatment (HAART). This area of nursing has readily adopted holistic nurse-led care. The National HIV Nurses Association has produced competencies (2007) to be a framework for nurses working in HIV; level 3 is particularly helpful to apply to specialist and advanced nursing roles. These competencies have been applied to a case study, the Nottinghamshire HIV CNS. A way to clarify a role is by evaluation and it is suggested that the structure-process-outcome model can be applied to specialist and advanced HIV nurses, using the NHIVNA competencies to form nurse sensitive outcomes. This model is then applied to the case study of the Nottinghamshire HIV CNS and a possible framework for role evaluation is proposed.
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