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1.
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Demographics
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2.
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Vital Signs
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• Height
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• Weight
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• Pulse
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• Respiratory Rate
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• Temperature
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• Blood pressure
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• BMI (optional)
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3.
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Triage and Identification of Emergency Conditions
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• Based on IMAI Quick Check triage protocol within WHO-IMAI guideline
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4.
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Screening
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• Chronic cough
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• Malnutrition
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• Anemia
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• Genital/anal lesions
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• Discharge/other genitourinary symptoms in males with genital lesions
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• Previous HIV testing
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• Mosquito net
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• Tobacco use
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• Alcohol use
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• Sexual activity
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• Pregnancy in eligible females
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• Family planning in females
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5.
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Chief Complaint(s)
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6.
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Diagnosis
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• Based on MOH SIS diagnostic codes
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7.
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Treatment
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• 100% agreement, including labs, medications, and other treatments ordered
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8.
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Referrals
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• Including follow-up visits to the OPD, if any
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• Patient Age and Sex
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• Start and end time of consultation
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• Health center
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• Nurse education level
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• Years of OPD experience of nurse
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