Background Recommended HIV routine monitoring and investigations in the outpatient setting has become increasingly extensive. HIV clinics use different methods including proformas to record consultation visits. Due to time constraints, in a busy clinic, the recommended monitoring and investigations can be overlooked.
Aim To raise standards of monitoring and investigation of HIV attendees by reviewing our clinical proformas.
Method Three annual retrospective case notes review of 50 to 53 patients with HIV attending service for HIV related care. Standards were set based on national BHIVA standards. In 2011 an annual proforma was introduced, which was updated in 2012 to meet the BHIVA 2011 monitoring guidance. However, the annual visit was then long and time constraining, so in 2013 monitoring across three themed visits every 4 months was created using three new proformas.
Results In 2011 smoking history, vaccinations, alcohol use, STI screening and mental health issues were poorly documented failing to meet standards. There was an overall improvement in those areas in 2012 with the updated proforma and continued improvement when three themed visits were created (smoking 37% to 96%, alcohol use 35% to 88%, and Influenza vaccine recommendation 63% to 94%). Areas with initial higher results such as cardiovascular risk and urinalysis achieved even higher outcomes (80% to 100%, 92% to 96% respectively).
Discussion Updating proformas to produce three themed reviews each year increased standards further in most areas and has had a positive effect on the HIV clinic with staff stating it feels less rushed, feels more focused and easier to keep to time.
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