Implementation and evaluation of a Project ECHO telementoring program for the Namibian HIV workforce
Implementation and evaluation of a Project ECHO telementoring program for the Namibian HIV workforce
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DOI：
10.1186/s12960-020-00503-w
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发表时间：
2020-09-01
影响因子：
4.5
通讯作者：
Struminger, Bruce
中科院分区：
文献类型：
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作者：
Bikinesi, Leonard;O'Bryan, Gillian;Struminger, Bruce
背景：2015年至2016年，纳米比亚卫生和社会服务部(MoHSS)在非洲的10个临床地点试行了第一个艾滋病毒项目ECHO(社区健康成果推广)。实施ECHO项目的目标包括加强临床能力、提高专业满意度和减少隔离，同时应对抗逆转录病毒治疗权力下放期间艾滋病毒服务方面的挑战。方法采用混合评估方法对试点项目进行评估。方法包括项目前/项目后对医护人员知识、自我效能和职业满意度的评估；对持续专业发展(CPD)信用获得的评估；以及焦点小组讨论和深入访谈。分析描述性地比较了治疗前和治疗后的差异。分析定性的成绩单以提取主题和代表性引文。结果护士对临床HIV的认知总体提高了17.8%(95%可信区间12.2~23.5%)，提高了22.3%(95%可信区间13.2~31.5%)。职业满意度提高30个百分点。大多数参与者经历了减少的职业隔离(66%)和改善的CPD信贷渠道(57%)。定性的发现加强了定量的结果。试点后，到2019年5月，纳米比亚MoHSS项目ECHO扩大到40多个临床站点，为14万多艾滋病毒携带者提供服务。结论与美利坚合众国的ECHO项目的其他评价结果类似，纳米比亚的ECHO项目促进了正在进行的虚拟实践社区的发展。评价表明，纳米比亚艾滋病毒项目ECHO有能力提高医护人员的知识和满意度，并减少职业隔离。
Background The Namibian Ministry of Health and Social Services (MoHSS) piloted the first HIV Project ECHO (Extension for Community Health Outcomes) in Africa at 10 clinical sites between 2015 and 2016. Goals of Project ECHO implementation included strengthening clinical capacity, improving professional satisfaction, and reducing isolation while addressing HIV service challenges during decentralization of antiretroviral therapy. Methods MoHSS conducted a mixed-methods evaluation to assess the pilot. Methods included pre/post program assessments of healthcare worker knowledge, self-efficacy, and professional satisfaction; assessment of continuing professional development (CPD) credit acquisition; and focus group discussions and in-depth interviews. Analysis compared the differences between pre/post scores descriptively. Qualitative transcripts were analyzed to extract themes and representative quotes. Results Knowledge of clinical HIV improved 17.8% overall (95% confidence interval 12.2-23.5%) and 22.3% (95% confidence interval 13.2-31.5%) for nurses. Professional satisfaction increased 30 percentage points. Most participants experienced reduced professional isolation (66%) and improved CPD credit access (57%). Qualitative findings reinforced quantitative results. Following the pilot, the Namibia MoHSS Project ECHO expanded to over 40 clinical sites by May 2019 serving more than 140 000 people living with HIV. Conclusions Similar to other Project ECHO evaluation results in the United States of America, Namibia's Project ECHO led to the development of ongoing virtual communities of practice. The evaluation demonstrated the ability of the Namibia HIV Project ECHO to improve healthcare worker knowledge and satisfaction and decrease professional isolation.