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Learning Objective 1: Identify 3 factors affecting task shifting implementation process and benefits by HCWs.
Learning Objective 2: Describe three recommended strategies to enhance implementation process of task shifting.
Methods: Qualitative focus group study utilizing focus groups and personal interview with key informants was conducted separately among physicians and nurses in the HIV clinics of two tertiary teaching hospitals in Abuja Nigeria to investigate factors influencing implementation of the TS process. Data was digitally recorded, transcribed and analyzed to identify factors influencing TS process
Results:
- TS benefitted patients by decreasing wait time and increasing amount and perceived quality of care received which improved patient satisfaction and lowered risk of losing patients to follow-up.
- TS benefitted HCWs by decreasing physician workload and increasing amount of time spent with more complex patients. Nurses reported their expanded roles provided them new knowledge and skills that improved patient care.
- TS altered inter-professional dynamics. Nurses expressed improved relations based on increased respect for their patient care contribution. Physicians perceived nurses as challenging their status by “over-stepping” boundaries.
HCWs require more preparation to successfully implement TS. Nurses require more clinical training to manage ART patients. Physicians need a better introduction to the task-shifting process. More participatory implementation methods are needed to increase awareness, improve execution, increase multi-disciplinary communication, and clearly define new roles that TS creates for all HCWs including auxiliary, laboratory and pharmacy staff.