TPT 1 Routine Standard Operating Procedures (SOP) to ...

1 TPT 1 Routine Standard Operating Procedures (SOP) to review IPT Registers and Patient Care Booklets for TB screening (TX_TB) and TPT Initiation and Completion for PLHIV (TB_Prev) Routine Patient Care Booklet (PCBs) Review (TX_TB and TB_Prev) Assign a focal person to randomly select 10 Patient Care Booklets for Use the table below to record the following information:a. Screened for TBb. Investigated for TBc. Bacteriologically confirmed (MTB+/SS+/C+)d. Diagnosed with RR/DR-TBe. Started on TB Treatment (Date and Registration Number)f. Eligible for TPTg. Initiated on TPTh. History of TPT/Completed Summarise data collected in Table: 1 below and develop a cascade to show information Table 1: TX_TB: Patient Care Booklet Reviews: Period of review ( 14-18 May 2018) Focal Person/Sister in Charge at time of data collection:# of patient recordScreened for TBInvestigated for TBSpecimen sentDiagnosed with TBDiagnosed with RR/DR-TBStarted TB Treatment(Date & RegistrationNumber)Eligible for TPTI nitiated on TPTDateHistory/CompletedTPTS creen Negative for Share cascade with facility staff/colleagues and discuss gaps and opportunities for TX-TB and TB_Prev Cascade.

2 Summary Table and GraphTotal # of patient records reviewedTotal # completed TPTT otal # eligible for TPTT otal # screened Negative for TBTotal # screened for TBTotal # screened Positive for TBTotal investigated for TBTotal diagnosed with TBTotal diagnosed with DR-TBTotal Started TB treatment6850546068886170102030405060708 0 Number of PatientsCompleted TPTE ligible for TPTS creened NegativeScreened for TBScreened PositiveInvestigated for TBDiagnosed with DR-TBDiagnosed with TBStarted TB Treatment50546068886172. TPT Routine IPT Register Review(TB_Prev) Assign responsibility to a focal person to review the register by using the table below to determine the month(s) for review according to the reporting Review for 6, 9 and 12 months retrospectively by using the table below for of Initiation(counted as the first month of treatment)

3 Month of report for 9 months completionMonth of report for 12 months completionMonth of Report for 6 months completionMayJanAprilOctJuneFebMayNovJul yMarchJuneDecAugAprilJulyJanSeptMayAugFe bOctJuneSeptMarchNovJulyOctAprilDecAugNo vMayJanSeptDecJuneFebOctJanJulyMarchNovF ebAugAprilDecMarchSept# of patient recordEligible for TPTI nitiated on TPTC ompleted 6 monthsCompleted 9 monthsCompleted in 12 Determine time of action and person Follow up weekly/monthly randomly selected files. Mark files with a sticker to indicate Show improvements quarterly. Display graphs in appropriate places within the facility, share them in management/staff meetings, include them in monthly Determine the number of initiations who.

4 Completed at least 6 months, determine % Number %Completed 9 months, determine % Number %Completed in 12 months, determine % Number % Use the table below to record the Focal Person/Sister in Charge at time of data Summarise data collected and develop a cascade to show information Share cascade and a pie chart with facility staff/colleagues and discuss gaps to address and opportunities for Determine time of action and person Follow up weekly or monthly. Randomly select 10 files. Mark files with a sticker to indicate Show improvements Summarize data collected and develop a cascade to show information graphically as illustrated Share cascade and a pie chart with facility staff/colleagues and discuss gaps to address any opportunities for of a pie Determine time of action and person Follow-up weekly or monthly.

5 Randomly select 10 files. Mark files with a sticker to indicate Show improvements quarterly. Display graphs in appropriate places within the facility, share them in management/staff meetings, include them in monthly reports051015200%25%50%75%100%Eligible forTPTI nitiated onTPTC ompleted 6 MonthsCompleted 9 MonthsCompleted 12 MonthsDidn t Complete#20%30%50%Completed 6 monthsCompleted 9 monthsCompleted 12 monthsDidn t completeTPT 2 Rapid Assessment Tool to Update IPT Registers and Patient Care Booklets for TPT Initiation and Completion for PLHIV (TB_Prev)Tools required:IPT Register(s)Patient Care BookletsData Collection FormsEPMS Information/ electronic system information1.

6 TPT Rapid Assessment Register Review(TB_Prev) Determine the period to update. (For example Oct 2016 Sept 2017) Do the updating by quarters to align with previous Assign a team of at least 3 people, including a leader to manage the Conduct a review on the current status of the register, using the Routine SOP guidance and provide a summary. Use the summary to compare with the rapid assessment review. This will help the purpose of record Prepare to review the register by listing the names of patients/registration numbers to assist in getting booklets from storage. Get a printout from EPMs/the Determine a safe place for review and the process of getting booklets and returning booklets to Review booklets and update the IPT register accordingly.

7 Booklets with names identified Booklets from within the time frame ( Oct 2016- Sept 2017) not recorded in the IPT Keep a list of all booklets/patients updated and all those recorded for the first Correlate information with EPMs/the system and update Summarise data collected and develop a cascade to show information Share cascade and a pie chart with facility staff and discuss gaps and opportunities for Determine time for any further action and person Revert back to the Routine SOP on a weekly/ monthly basis to review initiations for the week/ Use the table below to record the findings for Period to update ( Oct 2016-Sept 2017)

8 Determine solutions and date for implementation. Use the findings to implement a Quality Improvement Project/Quality Collaborative for Revert back to Routine SOP on a weekly basis.# ofPatient recordInitiated on TPT/Recorded/NEVER updatedInitiated on TPT/ NEVER RecordedInitiated on TPT/ UpdatedBooklets for further review/Indicate reason brieflyComments123456789102. TPT Rapid Assessment: Patient Care Booklet (PCBs) Review- (TX_TB and TB_PREV) Review booklets and update the IPT register accordingly. Booklets from within the time frame(October 2016- September 2017) not recorded in the IPT register Booklets of patients who started TB Use the table below to record the following information:a.

9 Screened for TBb. Screened + and Screened -c. Investigated for TBd. Diagnosed with TBe. Bacteriologically confirmed (MTB+/SS+/C+)f. Diagnosed with RR/DR-TBg. Started on TB Treatment (Date and Registration Number)h. Eligible for TPTI. Initiated on TPTj. History of TPT/Completed Keep a list of all booklets of patients started on TB Treatment and update the line list : Patient Care Booklet Review: RAPID Assessment: Period ( Oct 2016-Sept 2017)# of patient recordScreened for TBInvestigated for TB specimen sentDiagnosed with TBDiagnosed with RR/DR-TBStarted TB Treatment (Date & registration number)Eligible for TPTI nitiated on TPT dateHistory/Completed TPTS creened negative for Illustrative TX-TB and TB_Prev Cascade.

10 Summary Table and Graph01020304050607080 Number of PatientsCompleted TPTE ligible for TPTS creened NegativeScreened for TBScreened PositiveInvestigated for TBDiagnosed with DR-TBDiagnosed with TBStarted TB Treatment5054606888617 Total # of patient records reviewedTotal # completed TPTT otal # eligible for TPTT otal # screened Negative for TBTotal # screened for TBTotal # screened Positive for TBTotal investigated for TBTotal diagnosed with TBTotal diagnosed with DR-TBTotal Started TB treatment685054606888617# of patient recordHistory/Completed TPTI nitiated on TPT DateEligible for IPTS creened Negative for TBScreened for TBScreened Positive for TBInvestigated for TBSpecimen sentDiagnosed with TB DR-TBStarted TB Summarise data collected in the table of your choice above and develop a cascade to show information graphically.