Today was spent shadowing a nurse while she went through her patient consults (encounters) for that day. I'm finally starting to figure out the whole process! Here's what I've determined so far:
1. Patient checks in to the Reception area with their HIV Tracking booklet and insurance card.
2. Patient is given a number and their chart is pulled.
3. Nurse is given stacks of patient charts in the order that she should see them. She then calls patients in one by one.
7. Nurse also records current visit date and next visit date, in addition to any changes in medications, in each patient's HIV Tracking Booklet, Kubonana na Muganga (see below!).
1. Patient checks in to the Reception area with their HIV Tracking booklet and insurance card.
2. Patient is given a number and their chart is pulled.
- Each patient chart (Fr: Dossier) contains a colored dot that corresponds to one of the nurses. Each patient has the same nurse each visit (unless their assigned nurse is on leave).
3. Nurse is given stacks of patient charts in the order that she should see them. She then calls patients in one by one.
- Depending on the number of nurses present (there are 4 but on average 3 are present each day) and the number of patients, nurses see anywhere from 20-40 patients per day.
- WE-ACTx averages about 1,800 patients per month.
4. Nurse screens for TB and STI's and takes the patients weight to monitor BMI.
- A positive screening for TB is indicated if the patient reports any of the following:
- Productive cough
- Fever
- Weight loss
- Decreased appetite
- Vomiting
- Fatigue
- A positive screening for STI is indicated if the patient reports any of the following:
- Gential discharge
- Genital itching
- Lower abdominal pain
5. Nurse evaluates patient's adherence and educates them if necessary.
6. Nurse records patients visit in their chart (Dossier).
7. Nurse also records current visit date and next visit date, in addition to any changes in medications, in each patient's HIV Tracking Booklet, Kubonana na Muganga (see below!).
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| This is where HIV positive patients track their current medications (prophylaxis, ARV's) and appointment dates. |
8. Nurse gives patient a prescription for their ARV's, Bactrim and any other complaints.
- Patients today also complained of sinus infection, cough and possible pregnancy.
9. Patient goes to lab for any tests, pharmacy for medications (including ARV's) and reception to check out.
10. Patient completes a guided research assessment with one of the staff about their family members and whether or not they've all been tested for HIV.
