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<h3><!--mstheme--><font color="#003366"><a name="partner">partner</a> notification standards<!--mstheme--></font></h3>
<p><font size="2">(published in ‘The Clinical Management of Genital Chlamydia Infection’.
Central Audit Group in Genitourinary medicine. Nov 1997)</font></p>
<p><font size="2">These standards have been developed by the Society of Health Advisers in Sexually
Transmitted Diseases using the documents ‘SHASTD Partner Notification
Guidelines’ ratified at SHASTD's Annual General Meeting in 1995, and 'the Clinical
Management of Gonorrhoea' (see Int J. STD AIDS 1996; 7: 301)</font></p>
<p align="justify"><font size="2">What follows is directed at departments of genitourinary medicine
(GUM). Practitioners working in other settings should consider the advantage of referring
patients to GUM services where these standards are operational. Consideration should also
be given to other methods of joint working, such as by sending the department of GUM
copies of positive chlamydia results, or employing health advisers to liaise between
different services carrying out chlamydia testing.</font></p>
<h3><!--mstheme--><font color="#003366">Standards<!--mstheme--></font></h3>
<p><font size="2">I) Each clinic should have an adequate provision of health adviser time.</font></p>
<p><font size="2">2) The health advisers should have soundproof rooms for interviewing patients, and
sufficient administrative support.</font></p>
<p><font size="2">3) All patients diagnosed with chlamydia should have partner notification raised with
them when they are informed of their diagnosis.</font></p>
<p><font size="2">4) All patients with chlamydia should be referred to a health adviser, or someone
acting in that role in liaison with health advisers.</font></p>
<blockquote>
<!--mstheme--></font><!--msthemelist--><table border="0" cellpadding="0" cellspacing="0" width="100%">
<!--msthemelist--><tr><td valign="top" width="42"><img src="../_themes/shastd2/shasbul3.gif" width="35" height="24" hspace="3" alt="bullet"></td><td valign="top" width="100%"><!--mstheme--><font face="verdana, Arial, Helvetica"><font size="2">the doctor / nurse should present seeing the health
adviser as an integral part of the patient's chlamydia management</font><!--mstheme--></font><!--msthemelist--></td></tr>
<!--msthemelist--><tr><td valign="baseline" width="42"><img src="../_themes/shastd2/shasbul3.gif" width="35" height="24" hspace="3" alt="bullet"></td><td valign="top" width="100%"><!--mstheme--><font face="verdana, Arial, Helvetica"><font size="2">clinics should aim at a minimum standard of 90% of
patients with chlamydia seeing a health adviser</font><!--mstheme--></font><!--msthemelist--></td></tr>
<!--msthemelist--></table><!--mstheme--><font face="verdana, Arial, Helvetica">
</blockquote>
<p><font size="2">5) Failure or refusal to see a health adviser should be documented. The specific reason
for refusal/failure should be noted. Partner notifrcation should then be undertaken by a
doctor.</font></p>
<p><font size="2">6) A full sexual history of the index patient needs to be obtained, including types of
contact and condom use.</font></p>
<p><font size="2">The relevant period for partner notification is often difficult to ascertain in
chlamydia.</font></p>
<h3><!--mstheme--><font color="#003366">Recommendations are;<!--mstheme--></font></h3>
<blockquote>
<!--mstheme--></font><!--msthemelist--><table border="0" cellpadding="0" cellspacing="0" width="100%">
<!--msthemelist--><tr><td valign="top" width="42"><img src="../_themes/shastd2/shasbul3.gif" width="35" height="24" hspace="3" alt="bullet"></td><td valign="top" width="100%"><!--mstheme--><font face="verdana, Arial, Helvetica"><font size="2">in men with symptomatic chlamydia contact trace
partners over the last four weeks prior to the onset of symptoms</font><!--mstheme--></font><!--msthemelist--></td></tr>
<!--msthemelist--><tr><td valign="baseline" width="42"><img src="../_themes/shastd2/shasbul3.gif" width="35" height="24" hspace="3" alt="bullet"></td><td valign="top" width="100%"><!--mstheme--><font face="verdana, Arial, Helvetica"><font size="2">in women, and asymptomatic men, contact trace
partners over the last six months or until the last previous sexual partner (whichever is
the longer time period).</font><!--mstheme--></font><!--msthemelist--></td></tr>
<!--msthemelist--></table><!--mstheme--><font face="verdana, Arial, Helvetica">
</blockquote>
<p><font size="2">7) There should be a clinic protocol for the partner notification work of the health
advisers. This will have been negotiated between the health adviser and consultant, and
will be understood by all members of the GUM team.</font></p>
<p><font size="2">8) Each clinic should have a clinic protocol for:</font></p>
<blockquote>
<!--mstheme--></font><!--msthemelist--><table border="0" cellpadding="0" cellspacing="0" width="100%">
<!--msthemelist--><tr><td valign="top" width="42"><img src="../_themes/shastd2/shasbul3.gif" width="35" height="24" hspace="3" alt="bullet"></td><td valign="top" width="100%"><!--mstheme--><font face="verdana, Arial, Helvetica"><font size="2">notifying patients with a diagnosis of chlamydia:
clinics should aim for 90% of patients to be informed within two weeks of the test being
taken</font><!--mstheme--></font><!--msthemelist--></td></tr>
<!--msthemelist--><tr><td valign="baseline" width="42"><img src="../_themes/shastd2/shasbul3.gif" width="35" height="24" hspace="3" alt="bullet"></td><td valign="top" width="100%"><!--mstheme--><font face="verdana, Arial, Helvetica"><font size="2">recalling patients with an untreated infection - the
aim should be within one week of a positive result or missed appointment</font><!--mstheme--></font><!--msthemelist--></td></tr>
<!--msthemelist--><tr><td valign="baseline" width="42"><img src="../_themes/shastd2/shasbul3.gif" width="35" height="24" hspace="3" alt="bullet"></td><td valign="top" width="100%"><!--mstheme--><font face="verdana, Arial, Helvetica"><font size="2">recalling patients for follow up</font><!--mstheme--></font><!--msthemelist--></td></tr>
<!--msthemelist--></table><!--mstheme--><font face="verdana, Arial, Helvetica">
</blockquote>
<p><font size="2">9) The agreed contact action should be documented for each sexual contact eg whether
there is to be index referral, provider referral, contract referral or no referral</font></p>
<p><font size="2">10) Partner notification resolution should be followed up and documented at subsequent
visits</font></p>
<p><font size="2">11) Documentation should be accurate and complete.</font></p>
<p><font size="2">12) Verification of contact attendance should be sought where possible.</font></p>
<p><font size="2">13) As a minimum standard 70% of index patients should have at least one contact
attending.</font></p>
<p><font size="2">14) The use of contact slips should be encouraged.</font></p>
<p><font size="2">15) Each clinic should have a policy for the management of contact slips eg how the
contact slip information is documented or cross referenced in the notes, how the contact
slip is attached to the notes, and how it is returned to the health advisers.</font></p>
<p><font size="2">16) Health advisers should return contact slips to the issuing clinic within 4 weeks of
the contact's attendance.</font> </p>
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