NSW Health Sexual Health Services - Standard Operating Procedures manual

NSW Sexually Transmissible Infections Programs Unit

Section 1: Clinical Prevention
Sexual Health Outreach STI Testing

  • Introduction

    Outreach testing aims to increase access to Sexually Transmitted Infection (STI) testing (chlamydia, gonorrhoea and syphilis) for priority populations (as defined in NSW Health STI Strategy) by providing testing opportunities within non-traditional settings. It supports health promotion activities and normalises STI testing as part of health seeking behaviour. Outreach testing locations will align with places and events frequented by priority populations. This includes settings within and outside local health district (LHD) facilities.

    HIV point of care testing will be attended utilising NSW Framework and Standard Operating procedure for HIV point of care testing GL2019_010

    This standard operating procedure applies to three different categories of staff/service providers:

    1. NSW Health clinical employees - sexual, reproductive and woman’s health clinical staff e.g. registered nurses, enrolled nurses and medical officers.
    2. NSW Health non clinical employees - staff who are not employed in a clinical role within a publicly funded sexual health service (PFSHS), i.e. health promotion staff, youth workers and Aboriginal health staff.
    3. Peers, volunteers and non NSW Health staff i.e. ACON and youth peers and Aboriginal Community Controlled Health Services (ACCHS) workforce.
  • Outcomes

    Increase access to STI testing for priority populations.

  • Procedure

    Planning

    Develop an offsite activity plan (e.g. Down to Test Event Pack) to include the date, location, purpose and nature of the event and expected outcomes. Include the organisations involved and designations such as the health services outreach activity coordinator, clinical representatives including a clinical lead on the day and participating staff details.Undertake a risk assessment for the offsite activity considering staff and client confidentiality and safety plus personal and health service property. Identify and mitigate common/expected issues.

    To ensure outreach staff have professional indemnity and liability insurance whilst attending the outreach location, make contact with the LHDs senior risk advisor to complete the necessary forms; an example of this is the South East Sydney LHD (SESLHD) risk management plan and the SESLHD Indemnity request from.

    A copy of the offsite activity plan and risk assessment should be centrally located so it is accessible by all outreach staff.

    Attendance should be pre-arranged with premise management or event organisers (festivals, sex on premises, brothels).

    Participating outreach staff should be orientated to their role prior to activity. This includes clinical accreditation if undertaking specimen collection as part of outreach activity.

    SAMPLE RISK ASSESSMENT TOOL - OTHER OFFSITE ACTIVITY

    This is a minimum requirement which is designed to help the worker assess and prepare for the safety when conducting other off-site visits. It should be consistently used for monitoring safety risks.

     

    Date : Location/Venue :
    Address : Contact number :
    Name and Signature: Date form completed :
    Current known risk level associated with providing this Visit/Service – Refer to Offsite Risk Assessment Tool Red
    		 Orange
    		 Yellow
    		 Green

    1. Agreement to participate in visit

    1.1   Are there any known safety issues in relating to this offsite visit or location? Y N N/A
    Note: What controls are in place to help manage any identified risks? List below
    1.2   Has the client/management of venue been advised of their rights and responsibilities towards safety of LHD Worker (such as) :

    • Meeting worker as per any prearranged plans (i.e. foyer, access gate) 
    • Firearms/other weapons locked away and out of view
    • Request that persons do not smoke around LHD Worker.

    Y

    		 N

     

    N/A

     
    Safety controls (includes security and any other risks) :

     

     

    2. Pre-visit

    2.1. Where relevant, has the employees/volunteers line manager provided approval to participate in activity?  

    Y

    		 N

    N/A
    2.2. Are arrangements in place to communicate with the event/organisations main contact person?
    2.3. Is equipment in good working order:
    Vehicle (including adequate amount of fuel)
    Mobile phone (charged and working)

    Y

    		 N

    N/A
    2.4. Will the premises be easy to identify e.g. a visible number, lighting?

    Y

    		 N

    N/A
    2.5. Are there any special entry or security instructions e.g. boom gates, intercoms?

    Y

    		 N

    N/A
    2.6. Is free parking available and close to where you will be visiting?

    Y

    		 N

    N/A
    Access and equipment Notes :

    3. During visit

    3.1. Is there mobile phone reception in the area? (check before leaving vehicle)

    Y

    		 N

    N/A
    3.2. Is vehicle parked in a well-lit area?

    Y

    		 N

    N/A
    3.3. Is vehicle secured and no valuables in sight to public?

    Y

    		 N

    N/A
    3.4. Identified on arrival or during visit any slip, trips, falls hazards

    Y

    		 N

    N/A
    3.5. Identified on arrival or during visit any security or other safety issues

    Y

    		 N

    N/A

    4. Post visit

    4.1.Where relevant, has health services outreach activity coordinator/line manager been notified that the visit is completed and safety status?

    Y

    		 N

    N/A
    4.2. Have any injuries or safety issues from the visit been reported to health services outreach activity coordinator/line manager?

    Y

    		 N

    N/A
    4.3. Do any safety risks from the visit need to be controlled before future visits to same clients/location?       If YES, you must record details BELOW

    Y

    		 N

    N/A
    4.4. Has the safety assessment been updated to reflect new / current safety risks?

    Y

    		 N

    N/A
    Post visit safety notes (includes safety issues identified during visit) –

    Staff Accreditation

    Responsibility for training, competency assessment and accreditation of non-sexual health staff in conducting outreach testing can be designated to PFSHS clinical staff.The Outreach Coordinator will ensure all non-NSW Health staff participating in outreach activities have:

    Note: some LHDs may have additional requirement such as valid Working with Children’s Check and evidence of immunity for some vaccine preventable infections.

    At activity

    Outreach activities must be conducted by a minimum of 2 staff members (can be a combination of Sexual Health staff, non-government organisations (NGO), other Health Service staff, and other sexual health service staff).All outreach staff including non-NSW health staff participating in testing activities, are required to uphold the NSW Health Code of conduct. This includes no alcohol or illicit drug use during shifts and client confidentiality must be maintained.

    NSW Health Staff must have their NSW Health Identification cards on their person at all times whilst conducting outreach activity.

    Outreach staff must have a working mobile phone with them whilst on outreach.

    Outreach staff must be guided by management when entering premises e. g. sex on premises venues/brothels, and leave if refused entry.

    Access to further sexual health information (e.g. SHIL card) should be provided.

    Infection Prevention and Control

    Infection control protocols must be followed. Refer to NSW Infection Prevention and Control Policy , in particular Section 6 Risk Mitigation Requirements. Consider use of Down To Test handwashing poster.Spills kits should be available on outreach and all spills managed utilising the NSW Health Clinical and Related Waste Management for Health Services Procedure

    Specimen Management

    Collect specimens as outlined in the STI Testing Procedure.Sexual health clinical staff on outreach are responsible for the management of specimens at all times.

    Specimen and pathology request forms must be labelled correctly, lids secured, placed in biohazard bags and transport container. It is important to check all specimens include completed pathology request forms and the patient identifiers match.

    Documentation

    Local sexual health policy will describe documentation and medical record management for outreach activities.Most LHDs have electronic medical record systems and responsibility for documentation in client record by non-clinical staff will be managed at individual LHD/ sexual health service.

    Obtain at least two methods of contact for the participant for result delivery.

    Result Management

    Pathology services will report any positive gonorrhoea results as part of the duplex NAAT testing even though gonorrhoea test was not requested.All chlamydia, gonorrhoea and syphilis results will be managed as per the NSW Sexual Health Results Management SOP.

    NSW Sexual Health Infolink may also fully manage documentation management, result delivery and referral to local services by prior arrangement.

    NSW Sexual Health Infolink can assist local PFSHS with delivery of results for participant with positive results who can’t be contacted.

  • References and Further Reading
    1. NSW Health Infection prevention and Control Policy
    2. NSW Health Consent to Medical treatment – patient information
    3. Clinical and Related Waste management for Health Services Procedures
    4. NSW Health Festivals Project Standard Operating Procedures Chlamydia Testing at Music Festivals
    5. NSW Health Festivals Project Down To Test Event Pack