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. |
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