ANDS Business Procedures - Government of Nova Scotia
Contents
1. can be created to reflect the data of interest i e all cases in NS residents all reported cases of enteric illness or Lyme disease stratified by acquired inside NS and outside NS etc 5 9 TRANSFERRING BETWEEN DISTRICTS e To facilitate transfer between districts of notifiable events the ANDS Trainer will contact the PH Application Specialist by email PHAPPSUPPORT gov ns ca ANDS Business Procedures v3 0 8 of 82. in the ANDS user manual and or Surveillance Guidelines 5 1 SEARCHING RECORDS e All notifiable records on a client must be searched in ANDS prior to entering a new notifiable record to ensure there is no duplication of the event 5 2 CASE ENTRY e Reporting through ANDS is required for reporting of all notifiable diseases and conditions except HIV AIDS from the DHAs to DHW Enhanced and urgent notification of diseases and conditions occurs through other procedures See the Surveillance Guidelines for disease specific reporting requirements e All cases with an episode date from January 1 2009 onwards must be entered in ANDS These cases are updated real time through ANDS and no notification is required to NS DHW when updates are made to cases with episode dates from 2009 onwards e Cases with an episode date earlier than January 1 2009 may be entered into ANDS in consultation with NS DHW Surveillance Team in order for these data to be accurately captured e Case counting guidelines have been developed to ensure that notifiable disease cases are not reported and counted twice and to provide consistency in how cases are reported and counted Please refer to Table 1 below TABLE 1 Description of various residency scenarios for notifiable disease cases and guidelines for determining the reporting jurisdiction Please Note For AEFIs all cases are counted where the immunization was received Residency Where the case is sce
3. NOVA SCOTIA Health and Wellness Application for Notifiable Disease Surveillance ANDS Business Procedures Document Created by ANDS Business Procedures Working Group ANDS Business Procedures v3 0 1 of 8 1 INTRODUCTION This ANDS procedures document is to be used in conjunction with other supporting resources e g ANDS User Manual Surveillance Guidelines and CDC manual to ensure consistent use of the application and to maintain accurate and complete entry of data Quality data will help to ensure quality reporting from ANDS information 2 GENERAL ASSUMPTIONS ANDS users understand public health work practice specific to communicable disease case management notifiable conditions reportable by law immunization and surveillance guidelines This document contains basic information regarding ANDS business procedures and will not answer all the questions that ANDS users may have This is a living document and will require regular updates as required Business procedure clarification will be done in consultation with representatives from the following Population Health Assessment and Surveillance Responsibility Centre Communicable Disease Prevention and Control Responsibility Centre CD Surveillance Subcommittee and Immunization Subcommittee PH Managers who manage CD programs oo 0 0 ANDS does not meet professional practice standards for documentation Detailed immunization and notifiable disease records meeti
4. anual and or the Immunization Manual 4 1 SEARCHING RECORDS e All immunization records for a client must be searched within ANDS prior to entering a new immunization record to ensure there is no duplication of the immunization event e All users with access to the immunization module only and not the notifiable disease module have access to immunizations entered in all DHAs e There is at least one role within each DHA that can search for immunization records for immunization events in all DHAs This dedicated person can look up immunization records for other staff members as required e Immunizations are entered in the District Health Authority where the immunization was provided or where the immunization is being first recorded if delivery was out of province or event is being back entered e Do not re enter or modify an immunization event that is already in ANDS from entry in another DHA ANDS Business Procedures v3 0 3 of 8 4 2 4 3 4 4 ENTRY OF RECORDS Use the new quick entry screen for entry of new immunization events For modifications to an existing record this quick entry screen cannot be used All immunization records public and non public funded from January 1 2008 onward are to be entered into ANDS This includes immunization from other provinces or countries Do not enter TB testing data into ANDS Documented immunization data will be entered into ANDS in order to create the most complete immunization
5. ate of symptoms use as preferred episode date 2 Clinical diagnosis date use if onset date not available 3 Specimen collection date use if onset date and clinical diagnosis date not available 4 Lab test result date use if onset date clinical diagnosis date and specimen collection date not available 5 5 RISK FACTORS e Risk factors are not entered for any notifiable diseases and conditions ANDS Business Procedures v3 0 6 of 8 5 6 CASE OUTCOME IN ANDS e The possible outcomes in ANDS are as follows 1 Alive Hospitalized definition hospitalized for any reason during follow up 2 Alive Hospitalized ICU definition hospitalized in ICU for any reason during follow up 3 Alive Not Hospitalized definition not hospitalized for any reason during follow up 4 Deceased 5 Unknown e For any existing notifiable disease cases in ANDS where a client has been entered with an Outcome of Alive Hospitalized do not make further changes to this Outcome status unless recording a death e For example if you select Alive Hospitalized do not change the outcome status to Alive Not Hospitalized after the client has been released from hospital e This field is relied upon to report on hospitalizations so it s imperative that if a client is hospitalized that the Outcome status remains unchanged so this is reflected in reports e The only exception as mentioned above where you would change the Outcome
6. f diagnosis housing Unknown residency unable to contact client e Cases lost to follow up Place of diagnosis Case residing e Canadian travelers to NS Province of residence outside of NS within Canada e International travelers to NS Place of diagnosis Determined on a case by case basis Case residing outside of Canada Reference Surveillance Guidelines 2011 Table 6 1 5 3 TIMING e Initial case entry including client information and mandatory fields pertaining to the notifiable diseases and conditions must be entered immediately with the exceptions of Hepatitis B and C Please see the Surveillance Guidelines for information on data entry for these two diseases 5 4 EPISODE DATE AND TYPE e ANDS allows the entry of only one episode date per case Entry of subsequent dates obtained during case management over ride the existing episode date in the system Epidemiologically the earliest date associated with a case of illness is preferred that is the date closest to the onset of symptoms e The earliest episode date and associated type is to be entered during initial case entry often specimen collection date Throughout the course of public health follow up and upon closing of the case the episode date and type should be updated when new information on the case is obtained e The following episode date types are available in ANDS to be used in the following order of preference 1 Onset d
7. field would be for recording a death Deceased cases e Ensure Deceased is selected in Outcome field in ANDS Hospitalized cases not deceased e Ensure Alive hospitalized or Alive Hospitalized ICU are selected in Outcome field in ANDS This field will remain Alive hospitalized or Alive Hospitalized ICU if the case was ever known to be hospitalized during case follow up for any reason Do not change if discharged alive from hospital 5 7 CLOSING OF CASES INVESTIGATION STATUS e Left to discretion of DHA to use as applicable to case management However once complete all investigations are to be closed in ANDS Please ensure all fields are updated prior to closing as indicated in the ANDS user manual 5 8 CASE RESIDENCE AND PLACE OF LIKELY ACQUISITION The City or Town field in ANDS reflects the city or town of residence of the client If the client is determined to be from out of province ensure OOP is selected in client City or Town field The field in ANDS Where was case s illness most likely acquired indicates the place of likely acquisition of illness It is possible to select from the following e In province e Outside of province in Canada e Outside of Canada e Unknown ANDS Business Procedures v3 0 7 0f8 By appropriately entering the city or town of residence of the client as well as the place where illness was most likely acquired reports
8. her DHA For immunizations delivered through the school based immunization program enter the school and grade of the individual at the time of immunization delivery For immunizations delivered as part of a series enter the dose number e g dose 1 of 3 doses of Twinrix IMMUNIZATION RECORDS OF CLIENTS WHO LIVE OUT OF PROVINCE In the event a client resides out of the province OOP and receives an immunization in Nova Scotia the immunization record will be entered in ANDS by the district where the immunization was provided In the event that a NS resident receives a vaccine out of province the immunization record will be entered into ANDS ADVERSE EVENTS FOLLOWING IMMUNIZATION Upon confirmation of an AEFI following the NS AEFI guidelines the ANDS field titled was there an AEFI following this immunization event will be updated to yes It is also necessary to create a record in the notifiable disease section of ANDS as outlined in the AEFI Quick Reference Guide If there is no record in ANDS of the immunization event which the adverse event followed obtain appropriate details to enter the immunization event into ANDS Once the immunization event is entered in ANDS create an AEFI event and link it to the appropriate immunization ANDS Business Procedures v3 0 4 of 8 5 NOTIFIABLE DISEASES AND CONDITIONS AEFIs Refer to the ANDS quick entry guides for further information regarding how to enter notifiable events
9. in HCN field Do not enter numbers into name fields City or town of residence If a client moves from one city or town to another the changed information needs to be updated in the subject information screen client demographics e For clients residing outside of Nova Scotia already entered into ANDS ensure OUT OF PROVINCE OOP is selected as their City or Town DHA If a client is not already entered in ANDS and the case proves to be residing out of province it should not be counted as a Nova Scotia case and should be referred to DHW Surveillance for referral to the appropriate jurisdiction see Table 1 3 3 DUPLICATE CLIENTS e Ifa duplicate client is found in ANDS public health staff will contact the ANDS trainer who will notify the PH Application Specialist by e mail through PHAPPSUPPORT gov ns ca The notification will identify which client is the duplicate to be removed and which client is to be kept The PH Application Specialist will work with district staff to validate that the client is in fact a duplicate and ensure that any applicable immunization or notifiable disease records are moved to the appropriate client e If there is a new client record with the same HCN as a record already in ANDS and they are different clients follow the steps outlined in the previous bullet 4 IMMUNIZATION Refer to the ANDS quick entry guide for further information regarding how to enter immunization records in the ANDS user m
10. nario Examples reported Case with e NS resident with one permanent Place of residence residence s in one DHA in NS address Case with residences in different DHAs in NS excluding students e Person who lives in one DHA most of the year but spends part of the year in another DHA e g cottagers e Person living in one DHA while working returning to another DHA when not working includes military personnel Place where the case spends most of the year Students living away from home e Students studying within the province Place of diagnosis Institutionalized cases excluding incarcerated persons e Person who is institutionalized for a short term e g patients in general hospitals or wards Place of residence e Person who is institutionalized for a long term e g residents of a nursing home Facility where case is staying at time of diagnosis ANDS Business Procedures v3 0 5 of 8 Incarcerated e Person incarcerated within NS Facility where case is staying persons at time of diagnosis Case with e Person who lives in one province Place where the case spends residences in most of the year but spends part most of the year both NS and of the year in another province another e g cottagers province e Person living in one province for part of the year while working returning to another province when not working Case without e Homeless persons Place o
11. ng district and professional documentation standards need to be maintained in the district These records may include detailed case report forms consent records or other documentation of the event Immunization records that are recorded in ANDS may not have been administered by PH staff 3 MANAGING CLIENT RECORDS 3 1 SEARCHING RECORDS e All records in ANDS must be searched prior to entering a new client into ANDS For details on how to search for clients please refer to the latest version of the ANDS User Manual e If your first search is unsuccessful use other search criteria prior to creating a new record refer to the ANDS user manual This practice will help minimize duplicate records in ANDS e Ifthe client exists in ANDS and there are no visible notifiable cases or immunization events further follow up is required The ANDS Trainer will need to contact the PH Application Specialist to investigate PHAPPSUPPORT gov ns ca ANDS Business Procedures v3 0 2of8 3 2 ENTRY OF CLIENT SUBJECT RECORDS SUBJECT INFORMATION e Clients are only entered into ANDS when presenting as a notifiable case or with an immunization event e Do not enter clients into ANDS if DOB and initials are not obtainable e g anonymous testing e The Health Card Number must be entered without spaces in order to ensure accurate data entry and to help prevent duplicate clients in ANDS For RCMP or military personnel use their unique identifier
12. record possible In the event where no date is provided for an immunization all reasonable efforts will be taken to obtain the date This may include follow up with a physician nurse individual or other If no date is confirmed for the immunization the record is not considered a valid immunization and is not recorded in ANDS Partial dates If only the month and year of the immunization date is known then the 15 day of the month is to be selected as the date of Immunization and the exact wording estimated date is to be entered in the free text field entitled lt Other site specify gt Immunization records provided to district public health offices from other providers such as First Nations family physicians travel clinics and occupational health are entered into ANDS School based immunization data will be entered into ANDS by December 31 of each year Immunization records to be updated at the time of primary school registration in addition to other Public Health encounters with clients Immunizations are entered in the District Health Authority where the immunization was provided or where the immunization is being first recorded if delivery was out of province or event is being back entered If a client has moved from OOP and provides PH with immunization information e g HPV enter the district where the client made contact with PH Do not re enter or modify an immunization event that is already in ANDS from entry in anot
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