How to investigate levels of Adherence to antiretroviral ... - INRUD

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Chapter 5 Data collection tools and how to modify, print and fill them in If a different number attend on different days or parts of days, add up the number for each clinic and divide by the number of clinics. o Example 1—If there are four days when there are two doctors or clinical officers, and on the fifth day, two extra specialists attend, then we would add up each day and divide by five. This would be (2 + 2 + 2 + 2 + 4)/5 = 12/5 = 2.4. o Example 2—There are three mornings when there are three doctors or clinical officers, two mornings with two doctors, and every afternoon there is one doctor. Then this would be 10 sessions (5 morning sessions and 5 afternoon sessions) with (3 + 3 + 3 + 2 + 2 + 1 + 1 + 1 + 1 + 1 + 1)/10 = 19/10 = 1.9. o Example 3—If there are four doctors or clinical officers present for two days, and one for three days the number would be (4 + 4 + 1 + 1 + 1)/5=11/5 = 2.2. Then the calculation for the number of patients per clinician per hour is (number of patients seen in a week) divided by (number of clinicians in an average clinic x the number of hours the clinic is open in a week). (This will be calculated automatically when the data are entered). Q11. The purpose here is to find the number of non-clinicians who work in an average clinic. If one person does more than one job, it is important to only count them once. So, if a nurse also does counselling, then s/he should only be counted once. If the person works in the community and not in the clinic, s/he should not be counted but should be mentioned below. Only paid professional staff based in the facility should be counted, so this does not include cleaners, for example. How many of the following staff working directly with HIV/AIDS patients do you have during a normal clinic? (count one staff only once) (Check while in the clinic) Number working nurses social workers nutritionist counsellors pharmacists pharmaceutical technologist other (specify) Total Then the calculation for the number of HIV/AIDS patients per week per support staff is calculated by dividing the number of patients in a week by the number of support staff. (This will be calculated automatically when the data are entered). Questionnaire Side Two Q12-14 For each question, enter Y/N—You must be able to see a copy of each of the guidelines asked for to mark a yes—it is not enough to be told there is one. 47
How to Investigate Adherence to Antiretroviral Treatment: An Indicator-Based Approach Q15. If the manager says a guideline is followed to start a patient on ART, then write Y and name the guideline in the next square. Otherwise write N. Q16. Ask how many days supply of ARVs are usually given to patients during their first month of treatment. Q17 Ask how many days supply of ARVs are usually given to patients after their first month of treatment. Q18. Mark Y for all that apply. Q19. Mark Y for all that apply. Q20. Answer Y/N—The definition of a private space is where a conversation can be had without being overheard. Q21-22 Ask whether the programme provides child care, food for patients on ART, and has a formal system for linking patients with support of another person on ART. Answer each Y/N or S (sometimes). Q 23 Ask whether the programme has formal links with the community such as churches or other organizations. Answer Y/N. Q24-25 Because there are so many different laboratory systems the two questions to ask are: Do you have a functioning laboratory system for measuring CD4 counts, so that results can be ready for the patient's next routine visit? Answer Y/N. Is both the test and transport for the test free for patients? Answer Y/N. The laboratory must be working and active that day. If it is not functioning then it does not count. If both Q24 and Q25 are Y, then the indicator of whether there is access to a laboratory for a CD4 count will also be Y. Otherwise the indicator will be N. Q26–28 Remember that the lists of medicines need preparing in advance. The ones given here are only suggestions. There are three columns for each of the three lists of drugs. The principles for filling in the three tables are the same. The present Y/N column For the present column, the drugs must be available and in date. It does not matter how many of them there are. For the number (#) of days in stock in last 90 days column 48
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