STLS: Documentation of Treatment

TB Treatment Card

Content

The Tuberculosis Treatment Card is a paper-based recording form that is kept in the institution treating the TB patient under the National TB Elimination Programme (NTEP). It is a pre-requisite documentation related to treatment services offered to TB patients under NTEP.

Uses of the TB Treatment Card

The TB treatment card is primarily used for:

Documenting administered drugs with their dosages
Documenting follow-up investigation results
Monitoring adherence to treatment
Recording adverse events
Recording treatment outcomes

There are two pages in the TB treatment card and details in each page is delineated in the table below.

Table: Parts of the Treatment Card; *Source: NTEP Training Module 2 for Programme Managers & Medical Officers, p. 105*
PAGE	DETAILS CONTAINED IN PAGE
The First Page	Patient details such as name, age, sex and address of the patient
	Type of disease
	History of anti-TB treatment
	Regimen prescribed and duration of treatment
	Results of investigation before and during treatment
	Comorbidity-related information
	Contact tracing and chemoprophylaxis details
	Social habits such as tobacco and alcohol use
The Back Page	Details of intensive and continuation phases of treatment including drug details and adherence monitoring
	Retrieval actions for missing doses
	Adverse events
	Post treatment follow-up, nutritional support details and remarks
	Treatment outcome

Important Points to Note

The TB treatment card is filled at the Peripheral Health Institution (PHI) when a patient is initiated on treatment.
The original TB treatment card is kept at the PHI and updated fortnightly.
A duplicate treatment card is to be given to the treatment supporter for documentation of daily events.
The treatment supporter should be trained on how to record the treatment card.
Details on the patient’s HIV status are not included in the treatment supporter’s copy to maintain confidentiality.

The figure below shows the 1^st page of the TB treatment card. Click here to access the full form in the NTEP Training Modules 1-4 for Programme Managers & Medical Officers, p. 223.

Figure: First Page of the TB Treatment Card; Source: NTEP Training Modules 1-4 for Programme Managers & Medical Officers, p. 223

Resources

NTEP Training Modules 1-4 for Programme Managers & Medical Officers, 2020.

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NTEP TB ID Card

Content

In the National TB Elimination Programme (NTEP), the ‘NTEP TB identity card’ is provided for their identification and record of clinical follow-ups.

The identity card is completed for each patient who has a Tuberculosis (TB) Treatment Card, and it is kept with the patient. Information from the TB Treatment Card is used to complete the identity card.

There are 3 parts in the NTEP TB identity card and details in each part is delineated in Table 1.

Table 1: Parts of the NTEP TB identity card; Source: NTEP Training Module 2 for Programme Managers & Medical Officers, p. 105
PART	DETAILS CONTAINED IN THE SECTION
The First and Second Part	Patient information
Name and address of the TB unit/ district
Treatment details of the patient including: Disease classification Type of patient Treatment provider Case definition Weight bands Dosage Sputum results Culture results Results of follow-up smear examinations Results of follow-up cultures Information on the date of treatment initiation Treatment outcome
The Back Part	Appointment dates for visits to NTEP facilities
Contact details of NTEP staff in case of side events/queries

The information contained in this card will help to continue treatment in case the patient is transferred or admitted to any other health facility any time during the treatment period. The TB identity card is shown in Figure 1.

Figure 1: NTEP TB Identity Card; Source: NTEP Training Modules 1-4 for Programme Managers & Medical Officers, 2020

Figure 2: Sample of a patient’s TB identity card

Resources

NTEP Training Modules 1-4 for Programme Managers & Medical Officers, 2020

Kindly provide your valuable feedback on the page to the link provided HERE

Transfer of TB Patient

Content

TB patients may not stay in one place throughout the treatment duration. When they move from one place to other, there should be a mechanism to hand over the responsibility of continuing the patient's treatment in a facility near the new place of the patient. This is the concept of patient transfer and can be easily managed in Nikshay portal.

The transfer module in Nikshay enables transfer requests of patients between Health Facilities (HFs) across the country.
Provision of shifting of patient from one HF to another is possible if the patient changes his/her residence for the purpose of treatment.
The requests are of two types: “Transfer In” and “Transfer Out”.
All transfer requests needs to be accepted by the “District/ TB Unit (TU)/ Peripheral Health Institute (PHI)” where the transfer request is made in order for it to take effect.
Transfer requests can be made to even the District/ TU level. However, it can be completed only once the “Transferred to PHI” has been assigned.

Figure: Transfer Management in Nikshay; Source: Nikshay Zendesk, Nikshay Knowledge Base, Advanced Transfer in Web.

Steps in Transfer of TB Patient

1. In Nikshay, the referring HF updates details from the current HF of patient to the HF where patient is being transferred.

2. The receiving HF gets the intimation about the transfer.

The patient transfer module also provides the provision to pull the patient belonging to another HF to the recipient HF. The accountability of the transferred patients is now with the receiving HF and the treatment initiating facility.

A separate transfer register is also available to get details about various transfers from and to a given district, which can be downloaded from Nikshay reports.

Resources

Assessment

Question	Answer 1	Answer 2	Answer 3	Answer 4	Correct answer	Correct explanation	Page id	Part of Pre-test	Part of Post-test
Transfer requests include "Transfer In" and "Transfer Out".	True	False			1	Transfer requests include "Transfer In" and "Transfer Out".		Yes	Yes