Right to Care
Job Description
The Nurse provides direct patient care and is licensed to perform general nursing duties such as diagnosis and treatment of disease, ordering and interpreting medical tests, performing routine nursing procedures and referring patients to senior medical practitioners when necessary. The nurse is also responsible for building capacity through mentorship of facility based staff in order to meet the 95-95-95 Malawi treatment targets.
The nurse is also responsible in supervising PIH facility based staff at multiple medium and lower volume health facilities. The Nurse will work directly with HDAs, Psychosocial Counsellor and Patient Supporter to ensure clients are linked, retained and referred to other required services including psychosocial support and community services. S/he is also be responsible for liaising and working with community partners and representing RTC at community level.
Responsibilities
a. Demand creation for HIV services
• Ensure demand creation services are offered in all facilities with fidelity using appropriate messaging tools
• Conduct health education in all designated health facility places i.e. ART clinic, ANC, and OPD
• Ensure demand creation roster for Psychosocial Counselor and Patient Supporters is available and implemented accordingly
b. Optimizing linkage to care and treatment
• Ensure patient supporters are placed at designated places where they can ably escort and link New HIV+ clients to ART and other treatment and services
• Ensure newly diagnosed HIV positive clients are assigned to patient supporters and are documented in the ART referral register and outcomes well documented
c. Back to care program and linkage systems
• The nurse will ensure all tracking systems related to back to care and linkage program are put in place in all facilities i.e. Standards operating procedures (SOPs), community directorate, facility based phones for tracing and monitoring tools.
• Ensure standard operating procedures and guidelines are followed on booking of clients for next appointment, generation of list of missed appointment and Lost to follow up, and others, transferring and documentation of clients and follow up of clients.
• Provide technical support on the implementation of back to care program to facility based staffs i.e. patient supporters, HIV diagnostic assistants, and Data clerk mentors etc.
• Document and report patient supporters tracing efforts and back to care outcomes on monthly basis.
• Identify challenges on back to care programs and devise strategies that will surmount the challenges using the available resources
d. Psychosocial counseling and support services
• Work directly work with patient support services and psychosocial counsellors in the provision of psychosocial supports to clients both at facility and community level.
• Ensure all monitoring tools i.e. patient support services, welcome services, registers, appointment diaries and progress notes are placed in all facilities providing the services
• Periodically conduct sit in observation assessments with PSS provide to check on the quality of counseling and services being offered to PSS clients
e. Peads ART optimization
• Ensure that the facility is providing optimized ART regimens in line with MoH guidelines
• Work closely with clinical teams to ensure all RTC supported sites have enough peads medicines/supplies, counselling and monitoring tools.
• Provide progress reports on peads optimization as requested by central office in accordance with PEPFAR and MoH requirement
f. HIV/TB Integration
• Ensure that HIV and TB is provided as one stop care
• Ensure TB screening tools are available and pasted in all service delivery areas
• Work closely with facility staff to ensure eligible clients are offered and have completed TPT Ensure linkage to diagnostics of all presumptive cases and link to care confirmed TB cases.
• Work with facility team to ensure availability of TB infection control measures at the facility
g. Viral load testing and result management
• Ensure that all clients due for routine and targeted VL are collected
• Work closely with facility staff to ensure that results are filed properly and documentation is complete in the viral load registers and patient master card
• Ensure that all viraemia clients are followed up according to PIH tracing and follow up protocol
• Provide Enhanced Adherence Counselling (EAC) and ensure complete documentation on the monitoring tools
• Ensure that all clients due for repeat viral load testing have second sample collected
• Work closely with facility staff to switch patients with confirmed failure and where possible send application to HIV drug resistant committee
h. DSD
Work with facility staff to enroll in DSD models that are available at the facility and community such as, IHCC/Viraemia clinics, teen clubs, community ART distribution and 6MMSD
i. Preventive services including PrEP
Work with facility staff to ensure preventive services such as PrEP are available at the facility and clients are offered, enrolled and managed accordingly
j. Cervical cancer
• Provide quality cervical cancer screening and provide treatment services to pre-cancer patients with available treatment options e.g. Cryotherapy
• Conduct mentorship on cervical cancer to other technical and support staffs.
k. Knowledge sharing and capacity building
• Conduct CPD sessions (Clinical presentation)
• Conduct one on one mentorship during ART clinic consultation Organize facility monthly clinical review meeting
l. Clinical systems mentorship
• Ensure national ART/TB guidelines, relevant clinical guidelines, procedures and SOPs are available pasted at designated points of service delivery and fully utilized.
• Ensure triage and referrals are conducted in line with MoH clinical guidelines.
• Conduct weekly check on availability and completeness of ART standard monitoring tools ART, Viraemia registers, ART Master Card etc.
• Check and verify the functionality of basic equipment (BP machine, weighing scales, stethoscope) Ensure that newly diagnosed HIV positive clients have started ART on the same day.
• Coordinate patient care with other clinicians as needed to insure continuity and following up on patients as needed.
• Coordinate and work closely with facility based staff in generating reports and ensure proper storage of records.
m. HIV and C19 PPE stock management
• m. HIV and Covid 19 PPE stock management
• Ensure adequate medicines and medical supplies and proper storage at the facility
• Ensure adequate PPE is available and all stock records including stock cards are update
• Compile and submit weekly Covid 19 narrative report and PPE consumptions report
• Ensure drugs and test kit stocks are physically organized on shelve
• Ensure drug stock are on shelves by expiration date, boxes clearly labeled and stock cards completed
• Ensure HUB site and HIV Dept. Logistics Unit contact list is posted in pharmacy
n. HR Management
• Serve as PIH point of contact at site level
• Supervise and mentor PIH district teams
• Ensure team members adhere to PIH policies, guidelines and values
• Monitor staff presence, sign-off on timesheets and ensure annual leave planning
• Conduct bi-annual appraisal
• Liaise with district leadership to troubleshoot when necessary
o. Reporting and M&E
• Coordinate and work closely with facility based staff in generating reports
• Compile and analyze data to monitor progress and identify gaps and address them accordingly
• Organize regular data driven meetings with PIH facility based staff and MoH providers
Qualifications Required
• Certificate in Nursing
• Certified ART and Cervical Cancer provider
• Minimum of 3 years working experience in community health issues particularly HIV/AIDS.
Preferred
• Diploma in community nursing or public health
• Demonstrated technical skills in HIV/AIDS care, treatment and support
• Good communication and didactic skills in English and Chichewa