Postgraduate Diploma in Clinical HIV/AIDS Management

Purpose

This qualification is aimed at developing practitioners who will be able to function independently as clinical specialists and also as researchers within a high HIV/AIDS prevalence environment. The qualification responds to the urgent need for highly skilled practitioners to render appropriate care to HIV/AIDS clients, their families and communities, who are in urgent need of preventive and promotive interventions, clinical care and treatment.

All students are required to have a relevant qualification in the field, such as an undergraduate Degree in Nursing or a MBCHB. All students entering for this qualification must have and maintain current registration with the relevant Professional Health Council, i.e., the South African Nursing Council (SANC) or the Health Professions Council of South Africa (HPCSA).

Rationale

The successful implementation of the many policies developed around health care requires health care practitioners who can translate these policies into practice through effective health delivery at community level. This competence is achieved through a problem-based learning approach (PBL) that deals with real problems and issues around the clinical management of HIV/AIDS. The qualification thus responds to the urgent need for highly skilled practitioners to render appropriate care to HIV/AIDS clients, their families and communities who are in need of preventive and promotive health interventions, care in illness and the treatment thereof.

The qualification targets the nursing or medical practitioner who is at the forefront of collaborative teamwork in the clinical management of HIV/AIDS. It is aimed at producing clinically competent practitioners who can take a leading role in the management of those both infected and affected by the HIV/AIDS pandemic. There is an urgent need for such specialised practitioners throughout South Africa, as well as by our neighbours in the rest of Africa.

The following are assumed

• Competence to practice independently in the provision of community-based health care, including the management of infectious diseases in the community.
• Basic understanding of research.

Recognition of Prior Learning (RPL)

Candidates may provide evidence of prior learning for which they may receive credit towards the qualification by means of portfolios or other appropriate forms of evidence, in accordance with the RPL policy of the Institution.

Access to the Qualification

Applicants must be currently registered with the relevant Professional Health Council and meet the criteria of one of the following:

• Bachelor of Nursing including General Nursing Science and Midwifery, currently practising in an HIV/AIDS related clinical facility.

Or

• Community Health Nursing with a minimum of one year's experience in a primary health care clinic and training in either Voluntary Counselling and Testing (VCT) or Prevention of Mother to Child transmission (PMTCT).

Or

• Bachelor of Medicine and Bachelor of Surgery (MBChB).

This qualification comprises 10 compulsory modules, all at NQF Level 8, which total 120 credits.

Modules

• Epidemiology and natural history of HIV, 3 credits.
• Clinical assessment and management of HIV infected adults and children, 10 credits.
• Infection control, 2 credits.
• Basic clinical assessment, diagnosis, treatment and care of HIV/AIDS and other opportunistic conditions, 35 credits.
• Initiating Antiretroviral Treatment and Chronic Management of HIV, 10 credits.
• Dermatological manifestations of HIV, 2 credits.
• Pharmacy Dispensing Course, 30 credits.

> Note: The Health Science Academy requires the production of a personal Portfolio of Evidence as part of the Assessment Criteria for the Drug Dispensing Course, following which a Certificate is awarded for a Drug Dispensing License.

• HIV in Women, including those with gynaecological problems and HIV in Pregnancy, 8 credits.
• Clinical mentoring in HIV/AIDS programmes, 5 credits.
• Introduction to Research, 15 credits.

1. Promote, maintain and restore health by applying integrated scientific knowledge in a critical-analytical way through the scientific approach of assessing, diagnosing, planning, implementing, evaluating and documenting holistic care of individuals with HIV, their families/significant others and communities.
2. Utilise problem-solving and clinical skills as an independent practitioner in order to manage care and treatment of HIV positive patients appropriately.
3. Manage and evaluate services at district, provincial and national levels within national health policies and international guidelines.
4. Conduct HIV-related research of a high ethical standard and quality and utilise evidence-based practices to promote the highest quality of care.
5. Utilise operational leadership skills and managerial competencies as a member of a multi-disciplinary team in order to improve the quality of health care.
6. Facilitate the learning process among fellow health-care workers by creating an environment conducive to learning.
7. Collect, analyse and critically evaluate information when providing care to HIV positive individuals.
8. Demonstrate, in the context of the clinic or hospital environment, an understanding of the theories, research methodologies, methods and techniques relevant to the field.
9. Practice according to ethical standards and deal with ethical issues in the specific contexts in which they occur.
10. Function effectively within the systems operating in a clinical or hospital environment, according to own required role/s and responsibilities.
11. Take full responsibility for decision-making and use of resources in the clinical or hospital environment and accept full accountability for actions of others where applicable.

Critical Cross-Field Outcomes

All the Critical Cross-Field Outcomes are addressed in this qualification.

The following Assessment Criteria may be applied individually or generically in an integrated manner across all the Exit Level Outcomes:

• Demonstrate an understanding of the epidemiology of HIV by providing an outline of the natural disease progression in HIV/AIDS.
• Examine the statistics on the current status of the global HIV pandemic and analyse the impact of HIV on people of the most affected regions.
• Analyse societal factors that have driven the spread of the pandemic.
• Apply scientific nursing principles in the assessment and management of HIV individuals in family and community contexts.
• Promote optimal health and prevent diseases through the effective use of the three levels of disease prevention, viz., primary, secondary and tertiary, for all age groups.
• Act professionally within the ethical legal framework of the nursing/health profession.
• Conduct a general physical assessment of both an adult and paediatric patient and deduce the correct staging process before initiating treatment.
• Demonstrate effective assessment, management and prevention of opportunistic illnesses in HIV positive adults and children.
• Utilise available technology when carrying out the physical examination and management of the patient.
• Demonstrate effective application of the National Drug Policy, the Essential Drug List.
• Demonstrate proficiency in conducting clinical case presentations.
• Present a brief overview on infection control in terms of the sources of infection and its prevention.
• Describe the application of universal precautions in relation to HIV.
• Demonstrate ethical and effective counselling and communication skills to the individual, family and community.
• Demonstrate skill in screening, monitoring and managing patients on anti-retroviral therapy and the timeous referral of patients when required.
• Demonstrate proficiency in the diagnosis and management of dermatological manifestations of HIV in adults and children.
• Demonstrate skills in screening, monitoring and managing patients on anti-retroviral therapy and timeously applying the referral processes of patients.
• Demonstrate skills in advising patients and/or significant others regarding the care and administration of drugs at home as well as follow-up/continuous care of individuals who are infected with HIV.
• Demonstrate understanding of prophylactic and anti-retroviral pharmaco-therapeutics.
• Explain in detail the process of Post-Exposure Prophylaxis (PEP) after occupational injuries and or rape.
• Demonstrate a sound understanding of the requirements for professional nurses to register as dispensers of medicines with the South African Pharmacy Council.
• Conduct follow-up/continuous care of individuals who are infected with HIV and are on any prescribed drugs.
• Explain the methods of calculating drugs in adult and paediatric clients.
• Demonstrate advisory skills regarding care and administration of drugs at home as well as follow-up/continuous care of individuals who are infected with HIV.
• Demonstrate proficiency in the assessment, diagnosis and management of genito-urinary and/or gynaecological problems in adults.
• Apply the principles of HIV therapy in pregnant women in antenatal care, during labour and throughout the puerperium.
• Describe the evaluation of pregnant women with HIV infection both pre- and postpartum, including exclusive breast feeding techniques.
• Demonstrate knowledge and skills in managing gynaecological conditions both during pregnancy and the non-pregnancy periods.
• Describe the mentorship cycle and distinguish between a mentor and a mentee.
• Discuss the principles that govern the mentorship relationship.
• Explain how mentorship can be used to support HIV related programmes within communities.
• Demonstrate requisite skills in facilitating learning.
• Demonstrate requisite skills in brokering, building and maintaining relationships through effective communication.
• Demonstrate an understanding of scientific research methodology.
• Conduct scientific research.
• Describe the methods of scientific and non-scientific acquisition of knowledge.
• Practice ethical considerations at all times when conducting research.
• Demonstrate an appreciation of the protection of human subjects.
• Write a fundable research proposal.
• Produce a completed portfolio of evidence for summative assessment.

Note: The Health Science Academy requires the production of a personal Portfolio of Evidence as part of the Assessment Criteria for the Drug Dispensing Course, following which a Certificate is awarded for a Drug Dispensing License.

Integrated Assessment

Assessment is varied according to the nature of the module (clinical, research, or content-based) but in all cases corresponds with the problem-based learning approach, incorporating the following features:

Formative Assessment

• Portfolio of evidence (primary tool).
• Completion of clinical logbooks.
• Case development and presentation.
• Practical demonstration under the supervision of the doctor or Primary Health Care nurse.
• Demonstrated participation in group discussion taking part in all roles within the group (chair, scriber and time keeper).
• Provision of constructive feedback to fellow students.
• Application of conflict management skills in mock situations.
• Tutorial attendance (tutorials are compulsory).
• Oral assessment for students with special needs.
• Block evaluation by students.
• Completion of assignments and class activities.

Continuous assessment is performed through clinic based, doctor supervised practice and the completion of 30 logbooks and 20 full case studies. These are submitted monthly during each contact block session. At the end of the period of learning, a portfolio is compiled on the basis of cases completed and the feedback received in that regard, to form part of the summative assessment.

Summative Assessment

- Portfolio of evidence, which must include

> Personal developmental aspects, meaningful learning and self directed learning activities.

> Evidence of progress: knowledge, skills and attitudes.

• Final three-hour written examination.
• Practical examination.