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THE NAMIBIA INTERNSHIP PROGRAM2012
Amber-lee Carrière, B.Sc, B. Sc. Pharm Candidate 2015&
Erin Ready, B. Sc. Pharm Candidate 2014
THE KATUTURA HEALTH CENTRE
• A public health clinic that serves approx. 9300 patients• Composed of 2 clinics: a main clinic and an ARV clinic Composed of 2 clinics: a main clinic and an ARV clinic,
located next door to each other• Daily internship duties included dispensing ARVs to y p p g
patients, counselling patients in English, basic Oshiwambo, and basic Afrikaans, assisting with inventory management, pre-packaging medications & replenishing stock on pre-packaging medications, & replenishing stock on shelves
OUR COWORKERS• Worked alongside our supervising g p g
pharmacist, pharmacy assistants, doctors, nurses, adherence counsellors, & researchers ,
• Interprofessional collaboration is emphasized at the clinic to deliver h lth t th ti t f KHChealthcare to the patients of KHC
• Not only did we learn from our coworkers, we also shared many , ylaughs and formed friendships
OUTREACH CLINICS• Travelled to the 3 outreach clinics associated with KHC in
Outjomuise, Groot Aub, and Dordabis• Manually dispensed medications and counselled patients of
these remote areas • Gained a new appreciation for what ‘access to healthcare’
meansmeans
WINDHOEK CENTRAL HOSPITAL
• Completed a 1 week placement at Windhoek Central Hospital p
• Introduced to the pharmacy practice settings on the cardiac, oncology, psychiatric, and maternity wardsWorked within the ARV • Worked within the ARV pharmacy
• Participated in the 60min Participated in the 60min counselling session for patients initiating HAART
• Reported AMRs to the World Health Organization at TIPC
PATIENT EDUCATION PROJECTS
HANDOUTS FOR PATIENTS INITIATING H.A.A.R.T.
COUNSELING TOOL
PATIENT SAFETY REPORT
• Developed a formal patient p psafety and pharmacovigilancereport for KHC
• Included recommendations for the implementation of an independent double check model of ARV dispensing
• Encouraged the reporting of AMRs to TIPC
• Based on information learned i h C di h in the Canadian pharmacy curriculum and models in place at Windhoek Central and Oshakati Intermediate Hospitals Oshakati Intermediate Hospitals
HIVQUAL WAIT TIMES FOLLOW-UP STUDY & CLINIC APPOINTMENT ADHERENCE CLINIC APPOINTMENT ADHERENCE
RESEARCH
• Wait times are a parameter used by HIVQUAL Namibia to measure and monitor the quality of HIV care delivered to patients across and monitor the quality of HIV care delivered to patients across the nation
• A follow-up study was conducted to evaluate the success of li i h f ll i it ti t d f d i 2010clinic changes following a wait-times study performed in 2010
350
400
Patient Wait Times - 18/07/2012
250
300
350
150
200
Tim
es (M
inut
es)
0
50
100Wait
-100
-50
00 2 4 6 8 10 12 14 16
Clinic Appointments and Stations
1. Arrival Time 5. Filing Out 9. Blood Sample Out2 V/S I 6 Ph i i ’ A i t t I 10 C lli I
Clinic Appointments and Stations
2. V/S In 6. Physician’s Appointment In 10. Counselling In3. V/S Out 7. Physician’s Appointment Out 11. Counselling Out4. Filing In 8. Blood Sample In 12. Pharmacy In
13. Pharmacy Out
140
Average Patient Wait Times by Hour - 18/07/2012
100
120
60
80
es)
7:00-7:598:00-8:59
20
40
Wait
Tim
e (Mi
nute
9:00-9:5910:00-10:5911:00-11:5912:00-12:5913 00 13 59
0
0
Wait until Visit length Wait until Visit length Wait until Visit length Wait until Visit length Wait until Visit length Wait until Visit length
V/S (BP, weight) File, Result Tracing Dr.'s Consultation Blood Sample Counselling Pharmacy
13:00-13:5914:00-14:5915:00-15:5916:00-16:59
-40
-20
-60Appointments
THE STAMP PROJECT
• To assist patients in locating • To assist patients in locating their follow-up appointment dates, we have designed simple stamps for use at KHC
E h t i t f • Each stamp consists of a symbol and a box within which the next appointment c t e e t appo t e tdate can be written
4 different stamps have been designed: 4 different stamps have been designed: Doctor, blood, pharmacy, and counselling
IMPLEMENTATION• Practitioners were encouraged to begin using the stamps, and as g g g p ,
they did so, to explain the purpose of the stamps to their patients
• Posters printed in English Oshiwambo and Afrikaans were hung • Posters printed in English, Oshiwambo, and Afrikaans were hung around the clinic to inform patients of the new system
• Passport boxes were labelled with stamp symbols
Counsellors were be equipped with a new counselling tool and • Counsellors were be equipped with a new counselling tool and recruited to help explain the stamp system to patients
LOOKING AHEAD TO THE FUTURE…
S 2013Summer 2013
• 2013 University of Toronto Pharmacy Interns to conduct follow up on project efficacy follow-up on project efficacy
TOP 3 FAVOURITE ASPECTS OF NAMIBIANPHARMACY PRACTICE
FINALLY, WHEN WE WEREN’T BUSY IN THE PHARMACY, WE…
W t h k Went shark cage diving in South Africa!
Went sandboardingin in Swakopmund!
Zoomed Zoomed through the Namib Desert Namib Desert on quad bikes!
Camped under the pbeautiful Southern Hemisphere stars! Hemisphere stars!
Climbed sand dunes at sunrise & sunset!
Learned traditional dances! dances!
Tasted traditional cuisine!
Saw lions, l h t i ff elephants, giraffes
& more at EtoshaNational Park!
Cheered as Namibia beat Kenya 1-0 in Kenya 1 0 in the FIFA World Cup Soccer Cup Soccer Qualifier game!
Made wonderful ade o de ufriends and created lasting memories! lasting memories!
We would like to extend an enormous thank you to the staff of the Katutura Health Centre and the
THIS WAS AN EXPERIENCE OF A LIFETIME…
pharmacy staff of Windhoek Central Hospital for welcoming and accommodating us throughout internship! The knowledge and experiences we’ve gained from this experience will be sure to positively influence the rest of our pharmacy education and shape our futures as health care professionals We hope that the projects we left behind at the Katutura Health Centre will continue professionals. We hope that the projects we left behind at the Katutura Health Centre will continue to benefit patients and practitioners alike.
For helping make this experience financially possible, we would like to thank the University of Toronto International Health Program’s UTSU Discovery Fund, The Leslie Dan Faculty of Pharmacy Student Experiences Fund, and the Undergraduate Pharmacy Society’s Student Initiatives Fund.
Thank you also to our three University of Toronto supervisors: Mr. Aaron Yarmoshuk, Dr. Dan Thank you also to our three University of Toronto supervisors: Mr. Aaron Yarmoshuk, Dr. Dan Allman, and Dr. Jillian Kohler. We are very grateful to you all for providing us with this incredible experience!
THANK YOU VERY MUCH!BAIE DANKIE! BAIE DANKIE! TANGI UNENE!
CONTACT INFORMATION
Amber-lee Carriere
Erin Ready
Check out our blog at: http://namibiapharmacy2012.wordpress.com/
