Table 2.
Auditable recommendations and proof-of-concept adherence feedback for one ART clinic nurse and one clinical officer from the month of April, 2010
Auditable recommendation | Sample adherence for April, 2010 | |||
Individual | Clinic | |||
% | Ratio | % | Ratio | |
Nurse | ||||
1. If any symptoms are recorded as YES, then refer to a clinician | 33.3 | 28/84 | 40.4 | 415/1027 |
2. If fever is recorded as YES, then refer to a clinician | – | 0/0 | 62.5 | 40/64 |
3. If abdominal pain is recorded as YES, then refer to a clinician | 75.0 | 3/4 | 46.2 | 43/93 |
4. If vomiting is recorded as YES, then refer to a clinician | – | 0/0 | 83.3 | 15/18 |
5. If diarrhoea is recorded as YES, then refer to a clinician | 33.3 | 1/3 | 32.4 | 12/37 |
6. If weight loss is recorded as YES, then refer to a clinician | – | 0/0 | 85.7 | 6/7 |
7. If rash is recorded as YES, then refer to a clinician | 11.1 | 1/9 | 60.5 | 49/81 |
8. If leg pain or numbness in your legs is recorded as YES, then refer to a clinician | 25.0 | 8/32 | 37.2 | 105/282 |
9. If cough is recorded as YES, then refer to a clinician | 21.1 | 4/19 | 29.1 | 60/206 |
10. If yellow eyes is recorded as YES, then refer to a clinician | – | 0/0 | – | 0/0 |
11. If any unwanted changes in body shape is recorded as YES, then refer to a clinician | – | 0/0 | 100 | 10/10 |
12. If any other new symptom is … YES, then refer to a clinician | 58.8 | 20/34 | 46.5 | 276/593 |
13. If all symptoms are recorded as NO then the patient can be dispensed ARVs | 92.2 | 329/357 | 84.7 | 2757/3256 |
Clinical officer | ||||
14. CPT-eligible patients on CPT | 77.3 | 92/119 | 89.6 | 1206/1346 |
15. Adult CPT prescription: one tablet (480 mg) twice a day | 100 | 92/92 | 100 | 1206/1206 |
16. HIV-positive TB patients will start on cotrimoxazole according to the current CPT policy | 16.7 | 1/6 | 17.8 | 8/45 |
17. Stavudine should not be combined with zidovudine (AZT) due to pharmacologic antagonism | 100 | 85/85 | 100 | 1114/1114 |
18. All adults will now receive the stavudine-30 mg regimen | 100 | 85/85 | 100 | 1114/1114 |
19. The drug (lamivudine) should never be given as monotherapy | 100 | 92/92 | 100 | 1236/1236 |
20. Patients with acute hepatitis (manifested by jaundice) should not be given d4T/3TC/NVP | – | 0/0 | – | 0/0 |
21. In the case of jaundice or high suspicion of hepatitis with impending liver failure, d4T/3TC/NVP should be stopped | – | 0/0 | – | 0/0 |
ART, antiretroviral therapy; ARVs, antiretroviral drugs; CPT, cotrimoxazole preventive therapy.