site or Primary Care or Patient
Screening: Planning & Implementation
The following is intended
to help in planning health fairs as part of the Agape/Community Care clinical.
Material is divided into several functional sections. In each section there
are pointers for planning and implementation. Last update 9/2006
It is essential that
planning and taking care of details begin as soon as possible. Problems
often arise at the last minute, and if details are left until then the situation
The basic health problems/diseases
to be screened are hypertension, diabetes, asthma, body mass index, and breast
cancer. More may be added if resources and people are available. Examples
of additional areas include poison control, accident prevention, Hispanic
Nurses Association, Agape volunteer recruitment, CHIP/Medicaid assistance
(via Concilio), and others. Photo:
Current resources (these
are being updated) include UTSW Mobile Mammogram Screening Program, YWCA Mobile
Mammograms, EDHC community liaison, Agape director, Agape lay health promoter,
Dallas Independent School District (including PTAs and school nurses), American
Heart Association, American Diabetes Association, other national organizations,
and (for favors) cosmetics managers at large department stores. Also, see
above. In every case, contact must be made as soon as possible. Find new resources
- be creative!
Possible new or undeveloped
resources or tactics include holding a screening event at one of the
schools with whom we work (in conjunction with PTA meeting or school
event), Saturday screening, partnering with other churches, developing
additional resources for screening, and others.
The roles to be filled
are listed below. Volunteers are needed. Some will be able to commit only
to 2-3 hour blocks, which is just fine (greatest need for volunteers is in
planning & coordination. Important to involve others. Critical tasks include:
- Ensure that each major
area stays on track & on schedule (see schedule below)
- Maintain contact with
key outside resources such as mammogram team, East Dallas Health Center,
- Schedule all areas
of church needed (see the pastor and the church secretary; Open Door Learning
Center director). Agape staff should notify the church as soon as possible
when event is originally scheduled and students should follow-up when date
- Maintain contact
- During the event,
the manager keeps the event moving and solves problems. Stays in touch with
mammogram staff and others.
- Maintains list of
volunteers and participating agencies (name, address, phone, etc.) so we
can send thank you letters after the event.
- Stays calm!
& Personnel: Ensures that the following are in place. Important
to begin working on this as soon as possible.
- Greeter(s) to meet
people at the door and direct to screening or clinic, answer questions,
solve individual problems.
- Translator(s) - we
have never had too many, so push this as far as possible. Spanish-speaking
BU students should be recruited.
- Person or persons
to be in charge of each aspect of screening, e.g., one person for HTN, one
for DM, and so on.
- Tracker makes sure
that data sheets are collected when
patients are finished.
- If there are too many
volunteers, explore with faculty what we might do with them.
needed include the below. See specific areas for health-related supplies and
- Table signs
- Copier and extension
- Translators &
Volunteers as described above
- Plan with mammogram
team a date and time for the van to be stationed at the church parking lot.
- Contact pastor of
Grace United Methodist to ask permission to use the library and/or other
areas for the health fair. Be sure no conflict with other meetings or events.
- Encourage women over
40 to set up appointments for mammograms with the lead promotora. Everyone
in the clinic should participate in this. Make a brief flyer for clinic
staff outlining parameters (> 40 years, no Hx breast cancer, no breast
mass). This is ongoing until mammogram slots are filled.
- Assign students and
or volunteers to specific areas of screening (HTN, asthma, etc.).
- Go through available
materials to see what new is needed. Think in terms of areas to be screened
and roles. Gather display posters and health pamphlets regarding diseases
to be screened.
- It is essential that
any specific requirements of the mammogram screening unit be met, e.g.,
in fall 2006, several women were not screened because of documentation issues
(proof of residency).
- Obtain folders for
health teaching materials to give to each patient.
- Make flyers in English
and Spanish. These will be printed 2 sided. We have these ready to go. Check
with the instructor.
- Begin distributing
flyers. We advertised with flyers in the elementary school, the church where
it will be held, the church nursery, and during home visits to make the
community aware of the health fair. For a large fair, distribute at stores,
other churches, other elementary schools, senior centers, and so on. Distribution
of flyers is ongoing.
- Begin volunteer recruitment.
Baylor students are sometimes a good source. Work with CHN and patient education
faculty. Announce at Lunchencounter. This is a good learning opportunity
for J1s and J2s - as well as an opportunity for seniors to experience another
Four Weeks Before
- Inventory equipment
and supplies needed. Looking at how frequently we use particular supplies,
are we likely to need to order anything additional supplies? See below for
a list of what is needed according to area.
- Gather favors (i.e.
perfume samples, cosmetics, toothbrushes, breast cancer buttons, etc.) to
give to the women & sacks to put the favors in. This should be an organized
effort. Seek assistance from students, parents, spouses, etc. who are knowledgeable
about retail sales. Start early on this!
- Continue volunteer
and student recruitment as described above.
- Begin preparing folders
with important information regarding health problems and the church and
clinic services. Folders should have critical selected information as opposed
to everything we can stuff into the pockets.
- Map out the event
- walk through each station to check flow.
By two weeks
before the event, all tasks and equipment should be in place
- Check all equipment
to be sure working properly and that there are enough supplies (glucometer
strips, blood pressure cuffs, scales, alcohol swabs, stethoscopes, lancets
and disposal container, peak flow meters, mouthpieces, gloves, etc.). Persons
in charge of the screening areas will accomplish. Manager is responsible.
- Folders, handouts,
questionnaires, other administrative supplies are staged
- Gather decorating
supplies (i.e. tablecloths, streamers)
- Confirm volunteers
- Confirm other agencies
- Confirm with church
One week before
- Confirm with women who have appointments for mammograms that they will
- Review all previous steps to be sure everything is in place.
- Establish a procedure for handing off data sheets from (1) station to
station, (2) at end of screening cycle, and (3) for patients who need medical
attention during the event. For number 3, make a copy of the data sheet
to go with the patient's chart.
The day before
- Remind church and
learning center that the event is scheduled and that the mammogram van will
need to park next to church where school vans/bus usually park. Thank them
for understanding and helping.
- Set up the library
with the separate stations for each screening and tables with displays and
pamphlets on the diseases.
- Desk for sign-in set
up & stocked with plenty of pens and paper
- Lay out favor bags
- Re-check supplies
and function of glucometers
- Call volunteers and
remind them of what time to arrive to the health fair
The morning of
- Arrive 15 minutes
prior to unlock door and do any last minute preparation
- Stay calm
The week after the event
- Compile data on number screened, outcomes, anyone started on treatment,
- Set up phone or home visit follow-ups (with assist from CK).
- Write thank-you notes to everyone involved.
- Identify problems, new resources, new ideas and give to CK for inclusion
Basic order of
operations is as follows (change according to need/situation):
- Client sign-in (name,
address, phone number, and date of birth)
- History-taking (ask
clients questions from questionnaires) and blood pressures (BP are taken
early to prevent elevations r/t anxiety)
- Weight and height/calculate
BMI/diet and exercise teaching
- DFS if needed
- BSE teaching
- Collect data sheet
& give favors
- Mammograms in the
client has high blood pressure, high blood glucose, or other urgent health
problem, instruct them to complete the screenings and have an escort take
them to the Agape clinic with a copy of the data sheet for the chart. This
has been an area of confusion in the past and it is important that everyone
involved understand the procedure.
It is important that
there be a walk-through prior to the event and that everyone in the Agape
group participate. The walk-through should include patient(s) needing sick
should be one file folder or box for each station/job and these should contain
(in sheet protectors):
- Checklist for that area
- Originals of handouts
- Instructions for station volunteers
- Extra handouts
It is important that each clinical
group leave behind updated folders and materials.
(alta presion) and healthy heart teaching need
- Three regular BP cuffs,
1 large BP cuff, 1 medium/small BP cuff or Dinamaps (Check out LRC and ensure
correct accuracy and correct functioning)
on hypertension and healthy heart (Spanish & English)
- Be aware of current
guidelines on hypertension, e.g., different parameters for hypertension
with and without common risk factors, e.g., <130/80 with DM.
and heart risks (la altura, el peso, y reisgo del Corazon) need
- One to two scales
(get from clinic and check accuracy and correct functioning before event
on exercise, diet (foods high/low in sodium and fat), losing weight safely,
and related. Recipe cards or booklets should be provided
- Two glucometers (get
from clinic, ensure accuracy and correct functioning two weeks before event)
- Lancets, alcohol,
band aids, gloves (get from clinic)
- Call American Diabetes
Association for pamphlets
- Call Dallas Concilio
to see if they can come do screenings and teaching
- OJ or candy for those
who are hypoglycemic
on diabetes management (diet, foot care)
(las inmunizaciones) need - We usually do not offer immunizations as this
results in a marked increase in complexity
- Trained screeners
- Vaccines, syringes,
needle, alcohol, gauze, band aids, gloves (supplies from the clinic and
- Call Betty Lou Gary
- Acetaminophen or ibuprofen
to give before injection
- Toy box for children
Asthma (el asma)
need - We have had little return on asthma screening and for most events will
not screen for asthma
- Two peak flow meters
(get from clinic and ensure accuracy and correct functioning before event)
- Pediatric & adult
mouthpieces (get from clinic)
- Pulmonary function
machine (get from clinic)
- Instructions for screeners
on how to do screening.
- Charts with normal
ranges (kids, adults, male, female)
- Call Children’s
Medical Center (Debra Jiminez 214-546-1434 or 214-648-5418) to see if a
Spanish speaking asthma specialist can come
- Bubbles for prizes
- Handouts/poster on
asthma prevention and management
BSE (examiner los pechos) need
- Teaching on how and
when to do BSE using breast models (need breast models)
- Handouts/poster on
- Breast models from
- Cancer information
(an important screening area - significant numbers of positives in fall 2004)
The clinic will operate as on
other days, except that there will be two students from the Agape clinical
group to concentrate on the clinic and assist volunteers in working in the
clinic. We would like for as many volunteers as possible to rotate through
the clinic so that they can see how Agape operates.
A children's area with play and
related materials, especially crayons and the like is needed for most events.
With some lead time and sufficient resources this can be used as a developmental
screening area and opportunity to teach parents about developmental enhancement.
- Sereniti Young,
RN, Johns Hopkins Medical Center
- Cara Kerr,
student, Baylor School of Nursing
- Kristin Wong,
- Tara Thompson,