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Periodic Health Examination Training Program (P.H.ETP) 2014 PHETP

1National Periodic Health Examination Guideline

(Periodic Health Examination Project in Primary Health Centres)

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11Introduction to PHE:

PHE Timeline (Dobell) PHE started18611921 ?? the usefulness of AHE ( Morgan & Roemer) AMA policy for annual ex >35 1st Study by life insurance company19251945-1969197519791989-96 1st literature Frame &Carlson Canadian task Force for PHEUSPSTF Guide to preventive services

Benefits of PHE Provide physicians an opportunity to become familiar with their patients, and to establish a trusting relationship.

Stresses the importance of a healthy lifestyle.

Promote appropriate screening and prevention strategies.

Natural History of the diseaseStage of pathologic onsetPre-symptomatic stageClinically manifest diseaseDeathRecoveryDisability Primary Secondary Tertiary Preclinical PhaseP.H.ETP5

A primary goal of screening is the early detection of a risk factor or disease at a stage at which it can be corrected or cured.5Levels of preventionPrimordial PrimarySecondaryTertiary The action taken prior to the onset of disease, which removes the possibility that the disease will ever occur.The prevention of the emergence or of risk factors in countries or population groups in which they have not yet appeared The action which halts the progress of a disease at its incipient stage and prevents complications.All the measures available to reduce or limit impairments and disabilities, and to promote the patients adjustment to irremediable conditionsP.H.ETP6

Primordial prevention consists of actions and measures that inhibit the emergence of risk factors in the form of environmental, economic, social, and behavioral conditions and cultural patterns of living etc.

6Effective Prevention ProgramBased on scientific evidenceSupported by effective data systemFlexibleSensitive to ethical issuesTargeted to recipient most in needMuster a variety of community resources.Require legislative action and social policy decisionMust be continuous

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Vision To be a role model in achieving the health of the community leading to socially and economically productive life and achieving the Health strategic improvements goals of kingdom of Saudi Arabia

MissionTo provide gold standard evidence based, age appropriate, preventive and promotive health care through family practice in primary health care setting.

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Values

InitiativeJustice and EqualityTeamworkEmpowermentCommunicationQuality and ExcellenceMotivation

Aim & Objectives

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AIM To provide evidence based gold-standard and age-appropriate preventive & health maintenance care through family practice in primary heath care setting

AIM

- :1- .2- .3- .4- .Preventive & health maintenance services:Early detection of cases according to age groupProvide counseling and advice Age appropriate vaccination according to international recommendationChemoprophylaxis

Objectives of the project Referral of suspected or confirmed cases for management.Health education to the community about periodic health examination &early management of illness.

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Objectives of the project PHE Interventions: ChemoprophylaxisAnd Immunization

Counseling And Health EducationScreening and Early Detection of diseases

Targeted Groups:

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All age-group of family members.

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Project RationaleSupport the Ministry of Health and the conscious orientation to improve the preventive and promotive services.(Health Promotion) is the strategic goal within the first strategic plan for better future health in kingdom of Saudi ArabiaP.H.ETP

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2. Local orientation, regional and international for the application of the universal periodic examination of all age groups for the community to realize the concept of health to try to early detection of disease and the discovery of the most susceptible to the groups programsProject Rationale

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3. Increased demand and high ceiling clients and beneficiaries of the service expectations of size in the process of accelerating developments and scientific progress in the medical and technological fieldStrategies of Implementation of The Program

Adopt the concept of the Periodic health examination as a methodology to promote health

The integration of the periodic health examination program within the activities and services provided in public clinics, primary health care centers.

Guided by the recommendations of global guidelines and evidence based on scientific evidence.Utilization and investment of local and international experiences in this field.

The introduction of new programs such as immunizations program for adults according to the international recommendations.

Training and continuing medical education Following the methodology of training of trainers.

Provide and training manpower for skills of health education and counseling(counsellor.(

Providing preventive services currently available

Activation of referral between the various levels of health system.

PHE outcomes

Outcomes of the project: the primary (short-term)

Follow-up Program Performance with periodic reports and indicators of program performance33Project Outcomes: The final (impact)

The achievement of health and getting to a healthy society.34Stages of the implementation of project of the periodic health Examination program.

DContinuous improvement phase1434 H >>>>>>>>>>>>>>> 1438 H

Immunizations for adults program according to international recommendations Td) ). influenza) ). B Hepatitis B ) ). .(Pneumococcal polysaccharide) ( MMR ). . Meningococcal meningitis )). (Hepatitis A).Zoster.

GUIDE LINE METHODOLOGY

Methodology The Development committee of periodic health examination tried to find the most reputable international task force recommendation. They looked at the sources of evidence and the quality of recommendations.The evidences' resources were appraised using AGREE tool.Other sources of, evidences and recommendation to fill the gaps were looked for and references were cited accordingly.

Main Guideline usedMain: U.S. Preventive Services Task Force(USPSTF) www.ctfphc.org main Advisory Committee on Immunization Practices (ACIP)The Canadian Task Force on Preventive Health Care (CTFPHC)The Royal Australian College of General Practitioners (RACGP).

MethodologyStrength was based on the stated recommendation grading criteria.A or B recommended gradeThe panel members reach a consensus after discussing the recommendations which fill the gap based on: Currency, Applicability and Prevalence of the condition in our setting.

The mechanism of implementation of the program within the primary health care center:

Through the general clinics

The organizational structure within the primary health care center:

The PHE clinic nurseReceives the patient and welcomes him/her & fills the demographic data in the periodic health examination form Provide an idea about periodic health examination program, its goals and importance to the patient.

The PHE clinic nurseTakes the vital signs & calculate the height, weight & determine the body mass index Document the results in the patient's health record.Directs the patient to the physician.

GENERAL CLINIC PHYSICIAN perform the periodic health examination based on the PHE Form as follows: Assessment of the patient's history: Complete medical history, and the current complaint.Ask the patient about his/her current treatments, previous admissions to hospital. Inquire about the family history of the patient and history of allergies in details.Inquire about the social & psychological history.

GENERAL CLINIC PHYSICIAN Conduct medical examination based on the forms after taking permission from the patient.Document all lab results of the clinical evaluation in the forms.Laboratory and radiological investigation are requested based on patient assessment.

GENERAL CLINIC PHYSICIAN Refer the cases that need further testing and evaluation to higher level of health care. Counseling (refer to the policy of counseling and health advice).Updating patient immunizations.Schedule PHE according to the forms attached and patients circumstances.Direct the patient to the nurse in charge to give him next appointment.

Resources and needs of the periodic health examination clinic

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( )1 1 ( ) ( )1 (CBC) (BS) (Stool for occult blood) (TC, TG, LDL, HDL ( 0.4-0.8mg/day) ((not recommended ( ) (Td) (influenza) B (Hepatitis B (Pneumococcal polysaccharide) MMR ( Meningococcal ) (Hepatitis Azoster

Periodic health examination models according age groups:Periodic examination of the age group below 6 years.Periodic examination for the age group 6-17 years.Periodic examination for the age group 18-60 years.Periodic examination of the age group above 60 years.