Publichealth Professor Paula Tavrow from the University of California at LosAngeles says nurses in African clinics often don't have the time or thetraining to figure out what's wrong with patients who may be seriouslyill or have a hard-to-identify condition.
"Their inclination is to gofor a quick decision," Tavrow says. "Fever - it's malaria. Running nose- pneumonia. I mean, just really quick decisions."
For example, in manyplaces, Tavrow says nurses were not recognizing the symptoms of HIV inchildren. This meant the children didn't get into treatment - when itwas available - in time to make a difference.
So, Tavrow worked withexperts and local providers to create a simple notebook to help thenurses make more sophisticated clinical decisions. The health careprovider goes through a list of preprinted questions with the mother,asking about symptoms and checking off answers.
"So, they then ask themsome other questions. They assess whether the child has oral thrush andso on, and if the child has several of these risk factors, then themother is encouraged to take the child for an HIV test," Tavrowexplains.
In the clinic where Tavrow tested the booklets, she saysnurses went from never encouraging mothers to bring their child for HIVtesting, to suggesting it 21 percent of the time. She also says nurseswent from never asking mothers about their HIV status to asking aboutit 50 percent of the time.
Tavrow also developed a laminated chart tokeep on the examination table with lots of information that providersneed.
"This is just a very simple thing. It just has all of thetreatments all together, laminated. Put it right in your desk, justright in front of you, so that when you are writing your prescription,it's right there," Tavrow says. "You're looking down, becauseproviders don't want to seem like 'I am not knowledgeable' in front ofa patient. So if it's right there, they look. They don't have to sufferany sort of embarrassment."
Tavrow also says the laminated referencesaved nurses time. They didn't have to spend time looking for referencematerials or looking up treatments.
Tavrow says the nurses did a betterjob identifying children and mothers with HIV when they used thediagnostic aids.
She also says the providers liked the new tools. Theyreported that their work went faster. All of the nurses asked for moreproducts to help improve their diagnostic skills.
Tavrow says the bestthing of all is that these materials were low-cost. The booklets costless than 10 cents, and the treatment charts were about $2. She saysthis approach to expanding the diagnostic skills of nurses can beeasily replicated across the continent.
She recently presented her last month at the annual meeting of the .