PMTCT Nurse (HPC/RN2) - Bustamante Hospital for Children (BHC)

JOB PURPOSE

• To report social, biographic and clinical data relating to HIV, Syphilis and related diseases from Perinatal and/or Pediatric and/or Adolescent clients;  
• To monitor the elimination of mother to child transmission of HIV and congenital syphilis in Kingston.  

OBJECTIVE

• To ensure that the eMTCT guidelines (Option B+) as stipulated by WHO for HIV& Syphilis positive mothers are being met at the respective Treatment Sites so as to prevent the risk of transmission to the unborn child. 

RESPONSIBILITIES & DUTIES

• Responsibility for compliance with the eMTCT protocols, good clinical and applicable regulations
• Home visits  
• Database entry within 72 hours of child/neonate attending clinic 
• Assist the relevant medical officer in coordinating the evaluation and treatment of clients
• Facilitate periodic monitoring and/or Quality Control visits/audits 
• Ensure proper storage and security of eMTCT data 
• Contact and follow up patients, their families and other groups via telephone
• Interview and educate clients within the programme, while maintaining strictest confidentiality
• Assist in performing testing (e.g., Rapid HIV and syphilis testing) for clients
• Conduct post-test counseling with clients 
• Conduct physical examination of perinatal, pediatric and adolescent clients in clinics and wards
• Identify clinical signs and symptoms of HIV/AIDS, Syphilis and related diseases and conduct necessary referral 
• Assist the specialist medical officer in conducting initial assessments of all newly referred HIV positive and/or Syphilis reactive pregnant women in high-risk clinic
• Counsel women and adolescents regarding HIV and Syphilis, HIV and Syphilis testing, implications for their pregnancy, and the challenges of living with HIV 
• Assist with implementing SOPs for the treatment and prophylaxis of pregnant women and POC testing on the Labor ward  
• Monitor stocks of rapid test kits for HIV/Syphilis, HAART/ Penicillin  
• Educate women regarding the benefits of antiretroviral prophylaxis and Syphilis treatment
• Assist the physician in assessing and preparing patients for HIV and Syphilis treatment and/or prophylaxis against HIV, syphilis and opportunistic infections 
• Monitor clinical status and adherence to antiretroviral prophylaxis and Syphilis treatment, and provide continuing counseling and support during regular follow-up visits to the high-risk antenatal clinics 
• Assess and assist in addressing potential barriers to adherence to antiretroviral therapy and Syphilis treatment  
• Monitor syphilis treatment and post treatment testing during pregnancy and/or postpartum
• Ensure that treatment for HIV and Syphilis is provided as per protocol.  
• Ensure that other treatment is provided as indicated for complications of HIV, Syphilis or pregnancy. 
• Teach the principles of pill-swallowing to pediatric subjects 
• Perform intensive follow-up to support and educate families, while monitoring adherence to clinic visits, investigations, medications, and viral response, as appropriate 
• Enter key clinical data, biographic and demographic information into the programme data system
• Initiate efforts to find and counsel women who are delinquent for appointments, utilizing as needed, the services of local Contact Investigators and CHAs assigned to the HIV/STI/TB Programme 
• See, whenever possible, women with HIV and Syphilis who are in labour, or postpartum
• Provide HIV exposed infants with antiretroviral prophylaxis and nutritional support in collaboration with the specialist medical officer and nutritionists 
• Obtain blood for HIV virologic diagnosis by PCR/DBS at 4-6 weeks and 3 months after the first test. 
• Obtain blood for confirmatory serologic testing at 18 months and send to NPHL with necessary follow up 
• Provide Syphilis exposed infants with appropriate follow up until 18 months of age so as to ensure no clinical manifestations of Syphilis  
• Assist in training of staff at antenatal clinics, labour and delivery ward, and postpartum areas in HIV and Syphilis testing, prevention of mother-to-child transmission, care of the HIV positive and/or Syphilis reactive woman, and referral of children, adolescents and pregnant women. 
• Teach all staff the duty of respecting patient confidentiality and providing compassionate care to the HIV positive woman  
• Measure body weight, height, fundal height and other measurements, as appropriate.
• Attend and actively participate in relevant committee and team meetings 
• Travel to conferences and participates in other educational activities, as assigned (e.g.. at the Ministry of Health, Regional Health Authorities, UWI) 
• Any other job related duties to pediatric, perinatal and adolescent HIV/AIDS & Syphilis which may be assigned

KEY OUTPUTS

• Evaluation and Treatment of clients coordinated within the required timeframe
• Monthly, quarterly, and annual pMTCT reports submitted by stipulated deadlines
• Detailed Summary Report of the HIV Positive Child submitted  
• Data System updated with visits and key clinical, biographic and demographic information 

REPORTING RELATIONSHIP

• Overall supervision will be provided by the SMO, BHC 
• Direct supervision in by the Director of Nursing Services (DNS) 
• The Officer shall report indirectly to the Paediatric HOD, BHC 
• Indirectly reports to the Regional HIV/STI/Tb Coordinator  
• Indirectly reports to the KSA SMO(H) and STT MO(H)  

OTHER RESPONSIBILITIES 

• Performs other related functions assigned  

COLLABORATING RELATIONSHIPS 

• Paediatricians 
• Obstetricians 
• Social workers,  
• Pharmacist,  
• Psychologist,  
• Case Manager,  
• Adherence Councilors  
• Physicians,  
• Administrative Assistants,  
• Data Manager,  
• Other PMTCT nurses,  
• Staff in Antenatal and Paediatric Clinics, Labor Wards, Postnatal Wards, Emergency Room, Medical Records, Labs, Center for HIV/AIDS Research Education and Services (CHARES), Family Health Unit, Ministry of Health (MoH), Regional Health Authorities inclusive of their care facilities, the Project Coordination Unit of the HIV/STI/Tb Unit MoH, and other related organizations. 

QUALIFICATIONS AND EXPERIENCE

• Bachelor's Degree in Nursing 
• Registered Nurse (RN) with the Nursing Council of Jamaica 
• Certified Nurse mid-wife or Certified Nurse in HIV/AIDS care with at least three (3) years’ experience in general nursing
• Previous experience in counseling, phlebotomy, research, or public health nursing is an asset.

REQUIRED SKILLS AND SPECIALIZED TECHNIQUES

• Be knowledgeable of Jamaica’s HIV response and the eMTCT Initiative
• Proficiency in Microsoft Office & Google Docs 
• Excellent oral and written communication skills 
• Knowledge in Infection Control Guidelines and practices 
• Basic knowledge of Occupational Health and Safety 

SPECIAL CONDITIONS ASSOCIATED WITH THE JOB

• Exposure to highly confidential and sensitive information 
• Strict confidentiality must be maintained at all times 
• May be required to work beyond normal working hours in order to meet deadlines
• Is required to work in conditions where strict guidelines are provided on disposal of used equipment; sterility of equipment for sample collection and wearing protective clothing (e.g., gowns, gloves and masks).