Instructions:



|Policy Title: | |

| |Sexually Transmitted Disease Program |

|Program Area: |STD CLINIC |

| |STD program policy and Staff |Effective Date: |10/2002 |

| |Responsibilities in the one policy | | |

| |4/30/13 | | |

|Approval Date: |10/2002 |Revision Date(s): |6/05/2013, 3/20/2014, 12/04/2014, 1/25/2017, |

| | | |12/8/2017, 10/26/2018, 01/08/2019 |

|Approved by: |Kim Smith RN, BSN, MSHCA, Health Director |

|Approved by: |Elizabeth Kinlaw, ERRN, Renee’ Pridgen ERRN, Emily Lee, ERRN |

|Purpose: |

|Columbus County Health Department (CCHD) STD clinic program goals are to: |

|Provide testing for STDs |

|Provide treatment and cure as directed by NC STD Treatment Guidelines and standing orders signed by CCHD Medical Director. |

|Provide education/counseling to reduce future transmission of all STDs and coping with chronic sexually transmitted infections. |

|Provide outreach for care and management to exposed sex partners |

|Definitions: |

|The Health Department staff in cooperation with the medical consultant, the regional and State Disease Investigation Specialist, CCHD Medical Director, |

|and private physicians of Columbus County provides sexually transmitted disease control. CCHD staff will adopt and follow the North Carolina Sexually |

|Transmitted Disease Manual online @ . |

|Responsibilities: |

|CCHD STD clinic staff, management, community partners |

|Procedures: |

|A. Sexually Transmitted Disease (sexually transmitted disease) Control service shall consist of |

|Medical screening and treatment services will be available every working day on a walk-in first come first serve basis on Monday, Tuesday, and Thursday |

|from 1 pm to 3:30 pm and Wednesday and Friday 8:30 am until 11:30 am. |

| |

|Health History |

|Personal data |

|Present complaint |

|Past medical history |

|Sign/symptoms of venereal disease |

|Sexual history |

|Medication/allergy history |

|Occurrence of past venereal disease |

| |

|Blood pressure/ Temperature- Optional |

|HIV counseling |

|Physical assessment for Sexually Transmitted Disease with documentation on state form DHHS 2808. (control click on link). |

|Treatment of Sexually Transmitted Disease (if applicable) |

|Counseling and Anticipatory Guidance. |

|CCHD provided epidemiology service as: |

|Laboratory Services |

|Syphilis Screen |

|FTA-ABS |

|Gonorrhea culture for males only (G.C.) |

|Gram stain (G.C. smear) males only |

|Herpes culture if indicated |

|Wet mount-female only |

|Penicillin sensitivities on all positive gonorrhea cultures |

|NAAT GC/Chlamydia culture for females only |

|HIV Screen |

| |

|Health Education Service |

|The health department will provide STD education services to persons or groups as needed and as requested. |

|Professional education to update local physicians, nurses, and other professionals in the latest methodologies of STD control as needed and requested. |

|One-on-one client education including, but not limited to counseling at the time of treatment aimed at preventing re-infection or early recognition of |

|signs and symptoms of STD. |

|HIV Risk Reduction Education |

| |

|Referral Service |

|Promptly reports to the Division of Health Services all cases of publicly treated sexually transmitted disease in accordance with the following |

|schedule: |

|Cases of early syphilis (primary, secondary, and early latent under one year duration) will be reported by phone to The Disease Intervention Specialist |

|by the STD Nurse Coordinator. |

|All cases of STD’s by the health department and private facilities (except HIV, and Syphilis) will be reported via the North Carolina Electronic |

|Disease Surveillance System on a daily basis by the assigned processing assistant after being review by the ERRN STD coordinator. |

|Ensure that confidentiality of the records and clients right to privacy is maintained according to agency policy. |

|The health department encourages private laboratories and private physicians to meet the requirements of G.S. 130A-140 relating to reporting. |

|Encourage private physician to routinely report all cases of STD within twenty-four hours of treatment. |

|Encourage all non-health department laboratories to submit reports of all positive laboratory tests for STDs. |

|Ensure that physicians and laboratories not previously providing services within its area of jurisdiction are informed of proper reporting requirements |

|and procedures. |

|Follow-Up Service |

|Three attempts via phone or letter will be made by the STD Nurse Coordinator to have patients return for treatment when not treated on the day of exam. |

|Patient education and counseling are done one-on-one and documented. |

| |

|Recruitment and Outreach Service |

|Clients are recruited for health department sexually transmitted disease services through the health department clinics, hospitals, private physician's |

|offices, and from other health departments. |

|Outreach is provided by The Disease Intervention Specialist and the public health nurse, as indicated. |

| |

| |

| |

|Records |

|The problem oriented health record shall be used in the sexually transmitted disease program |

| |

|The STD records are incorporated into the electronic medical record (CureMD) and consist of: |

|Personal Data (DHS 2800) |

|Sexually Transmitted Disease Female/Male (Form DHHS 2808) |

|Note Sheet (DHS 2803) |

|Problem List (DHS 2801) |

| |

|Eligibility |

|Treatment services are available to all persons in the community who need them. (Drugs used in the treatment of sexually transmitted diseases are |

|provided by the State STD Control Program at no charge to the Health Department or patient). |

|Private physician referrals and follow-up are encouraged. |

|Clients presenting for screening on days or times other than those designated by this agency are to: |

| |

|Return to the health department clinic within one working day or less for evaluation and treatment. |

|If for some reason the patient cannot be seen within one working day refer him or her to their primary medical doctor. |

|If the patient does not have a primary physician instruct them to the Emergency Room or Urgent Care. |

|Charges |

|Screening and treatment services will be provided to all clients regardless of financial abilities. |

|Can bill Medicaid and or third party insurance if the patient agrees. |

|Quality Assurance |

|There will be quarterly program assessments and evaluation and corrective action plans as indicated. |

|Clinical record audits will be done according to department policy |

| |

|Program Procedures |

|Columbus County Health Department provides screening and treatment services for STD on Monday, Tuesday, and Thursday 1:00pm-3:30pm. Also Wednesday and |

|Friday 8:30am-11:30am. |

|Columbus County Health Department will assure access to care within one working day of request for care by clients needing evaluation for symptoms of |

|sexually transmitted infection or for exposure to sexually transmitted infection. |

|Epidemiology services are provided through STD Control Branch |

| |

|Routine Clinics |

| |

|Registration |

|Upon arrival, clients are received at front entrance desk. |

|A registration clerk will obtain record from the files, confirm the client’s name, updates the personal data information, checks record adding forms as |

|needed. |

|Personal Data Sheet |

|Obtain additional information including the number of family members, their names, ages, and relationship to clients. |

|Emergency telephone number(s) will be obtained. |

|Registration staff updates and signs Personal Data Sheet each visit. |

| |

|Responsibilities STD Clinic Staff |

| |

|Position Title: |

| |

|STD Nurse |

| |

|Position purpose: |

| |

|Functions in an expanded role providing primary care to patients, who have or are suspected of having, one or more sexually transmitted diseases (STD). |

|The STD program policies and procedures, inclusive of standing orders, are approved by the clinic physician back-up. Coordinates related activities to |

|ensure all common STDs are screened, actively investigated, treated and followed. |

| |

|Principle Responsibilities: |

|Provides direct care to patients requesting services including examination, screening and treatment under the STD policies and procedures. |

| |

| |

|Consults with the medical back-up or the (N.P. or P.A.) according to the clinic guidelines for patients with diagnostic problems or complications, or |

|for any other medical circumstances not covered in the written protocol. |

|Provides patient education regarding the disease process, treatment, necessary follow-up examinations and the importance of sex partner examination. |

|Refers patients to other appropriate community resources when findings indicate problems beyond the scope of the STD clinic. |

|Refers patients for disease intervention follow-up according to established clinic guidelines. |

|Triage for proper counseling and referral of symptomatic patients who cannot be examined and treated during clinic hours. |

|Documents all patient records, forms in electronic medical record and reports thoroughly and according to the requirements of each. |

|Reports deficiencies in charts found through chart reviews to other staff members for correction and review. |

|ERRN STD nurses coordinate appropriate follow-up examination appointments. |

|Orders appropriate STD medication from the state office as needed assuring adequate stock. |

|Reviews all STD clinic pending lab result tests when received for appropriate management and documentation. |

|Collaborates with regional Disease Intervention Specialist (DIS) in receiving, reporting and follow up of HIV and Syphilis cases. |

|Participates in staff meetings and continuing education programs sponsored by the clinic or other designated agency. |

|Assesses available educational resources for utilization with patients and other colleagues. |

|Maintains adequate and updated inventory of educational materials. Orders supplies (pamphlets, films, videos, etc.) as necessary. |

|Performs other related duties as assigned. |

| |

|Reportability: |

|Director of Nursing |

|Health Director |

|Laws and Rules: |

|10A NCAC 4 1A .0204, 10A NCAC 41 A .0202, 10A NCAC 41 A .0102, 10A NCAC 41 A .0101 |

|Reference(s): |

|NC Sexually Transmitted Disease Public Health Program Manual |

|The Pocket Reference Guide for Clinical Evaluation and Treatment of Clients with Sexually Transmitted Infections. |

................
................

In order to avoid copyright disputes, this page is only a partial summary.

Google Online Preview   Download