PACK Adult – Western Cape, South Africa
Practical Approach to Care Kit Adult
PACK Adult is a comprehensive clinical practice guideline that aims to equip nurses and other clinicians to diagnose and manage common adult conditions at primary level. The starting point is any of 40 common symptoms, each of which provides the opportunity to identify one or more of 20 important chronic conditions in the second half of the guideline. These include infectious diseases, chronic respiratory diseases, cardiovascular risk, hypertension and diabetes, mental health conditions, musculoskeletal disorders, epilepsy and women’s health. See sample pages and contents pages below.
Implemented initially as Primary Care 101 in the Eden district of Western Cape, South Africa as part of a randomised trial of its effectiveness, it was rebranded in 2012 to form part of the Practical Approach to Care Kit Package that includes a guide for community care workers (PACK CCW), patient information leaflets and still under development, PACK Child and PACK Counsellor.
The implementation of PACK Adult in Eden was preceded by a series of Chronic Disease Management Team workshops, the purpose of which was to identify roles and responsibilities, streamline task-sharing, troubleshoot around resource and prescribing issues, and prepare for the implementation of the programme. During 2013, six PACK trainers trained 206 health workers in 76 facilities in the district. This training and programme development model was regarded by the provincial Department of Health as best practice and roll-out to the rest of the province began. PACK training coverage has reached 80% of provincial facilities. PACK is updated annually to align with evolving policy, the review process consults stakeholders throughout the province.