Nurses' Experiences of Video Direct Observed Treatment at a Local Tuberculosis Clinic in a High‐Income Country: A Qualitative Study

INTRODUCTION: Tuberculosis (TB) is curable with effective therapy, but the treatment regimen is lengthy. The World Health Organisation (WHO) recommends that patients diagnosed with tuberculosis are provided with treatment support to assist them in adhering to and completing their treatment. One form of treatment support is Video Direct Observed Treatment (VDOT). AIMS: The main aim of this study is to explore nurses' experiences of video direct observed treatment at a local TB clinic in Australia. The secondary aim is to identify facilitators and barriers to video direct observed treatment. DESIGN: An interpretive-descriptive qualitative method was used in this study, which was conducted in Australia. PARTICIPANTS: Seven registered nurses who work or have worked at a local TB clinic and have used video directly observed treatment in the last 12 months. METHODS: Semi-structured interviews were conducted with the participants, and data were analysed using thematic analysis. RESULTS: The main theme unearthed in this study was keeping people safe, with five sub-themes found linked to keeping people safe, including: (1) Assessment of side effects and compliance, (2) physical safety, (3) work efficiency, (4), safe communication and (5). person-centredness. CONCLUSION: Keeping people safe is the overarching theme found in this qualitative study looking at nurses' perceptions and experiences of VDOT in a local TB clinic in Australia. Overall participants reported positive experiences with the VDOT programme; however, it was recommended that patients assessed as low risk for defaulting and not experiencing adverse events could be offered the option of reduced treatment supervision, with prolonged duration for self-administered treatment (SAT) as part of a person-centred model of TB care. PATIENT OR PUBLIC CONTRIBUTION: Nurses at a local tuberculosis clinic participated in this study and shared their experience with us. IMPACT/IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE: This is the first study in Australia to qualitatively explore nurses' experiences of VDOT. The results of this study could potentially enhance the current approach to TB care, emphasising a more person-centred care approach, thereby benefiting patients and the healthcare organisations in Australia and similar contexts. Also, the findings of this study, specifically the facilitators and barriers to VDOT could assist TB services in designing the inclusion and exclusion criteria for VDOT to ensure patient safety. REPORTING METHOD: Authors have adhered to the EQUATOR guidelines, 'Standards for reporting qualitative research (SRQR)' for this study.