PDF File - hivpolicy.org

An Evaluation of the MoH/NGO Home Care Programme for People with HIV/AIDS in Cambodia5.7 Record KeepingIf continuity of care for PLHA is to be maintainedthroughout the illness then it is importantthat a simple but effective system of patientrecords should be established and maintained.From a perspective of providing care, it hasbecome convenient to refer to five stages relatedto HIV infection:• people uninfected, but at risk• asymptomatic HIV+• early HIV disease• severe disease equivalent to AIDS• terminal illnessDuring the pilot phase, a system of recordkeeping using specially designed "yellow cards"was developed. Each patient was assigned acard which was used to collect data on thelocation of the patient, history of the disease,present condition, family situation, and currentmedication. The cards were held by the nearestHCT and were used for referrals when taking apatient for testing or to hospital. The cards alsoprovided a record of the evolving condition ofthe patient and could be used for monitoringprogress and planning appropriate homecare visits.During observations of home care visits, itwas noted that, while some teams continued touse these cards, there was no pattern ofconsistent use in other teams. Given the breakdownin the referral system with hospitals,there is perhaps some justification for discontinuingusing the cards. However, it was alsonoted that the standard of record-keeping wasgenerally uneven and sometimes inadequate.Maintaining good patient records is importantfor client monitoring, prioritising needs,planning visit schedules and structuring thevisits themselves.It is recommended that the Home CareNetwork Group reviews and strengthens thesystem of record keeping, planning andprioritising visits to patients.5.8 Monitoring & Reportingpg 545.8.1 Monitoring inputs and processThe issue of uneven quality of monthly dataon patient numbers and team activities providedby the HCTs to the Home Care NetworkGroup has been described in an earlier sectionof this report (Section 2.6, Methodology:Limitations of the Evaluation).It is recommended that the monthly figuresfor patients, visits and team activities arequality reviewed before each monthly HCNGmeeting, and that the HCTs reach a commonunderstanding with the Home Care NetworkCo-ordinator on the definitions of a home carevisit and a home care patient, for accountingpurposes.