Antenatal Care (ANC) – Routine Immunization Carepath

Purpose

The ANC Routine Immunization Carepath manages immunization services for pregnant clients. It automatically proposes Td (Adult) doses according to the ANC schedule, allowing clinicians to record vaccine administration, update pregnancy details, and track follow-up visits.

This workflow shows how to:

• Identify a pregnant patient

• Manually enroll into the ANC Routine Immunization Carepath

• View and start the scheduled ANC immunization visit

• Record vaccine details and pregnancy history

• Complete or discharge the patient

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Navigation

From the sidebar, expand Patients and select Search.

• Search using one or more identifiers.

• Open the View Patient page.

When Pregnancy Status is recorded as active, the ANC Routine Immunization Carepath will appear under Care Pathways / Plans. You must manually select Enroll to begin scheduling Td doses.

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Workflow

1

Review the ANC Immunization Schedule

After enrollment, the carepath displays Td doses scheduled based on prior DT/TD history and time remaining before EDD.

• Td1 appears if due and >14 days before EDD

• Td2 appears ≥4 weeks after Td1 and >42 days before EDD

• Td3 appears ≥6 months after Td2 and >10 days before EDD

• If fully vaccinated pre-pregnancy, no Td is proposed

• If partially immunized, one booster may be proposed

2

Start the ANC Visit

Open the scheduled Antenatal Care Visit (Immunization) and select Start Visit.

In the dialog, select From Care Plan – ANC Routine Immunization Carepath, then click Start Visit.

3

Record the Immunization (If Due)

Under Performing Today, confirm the pre-loaded Td (Adult) entry (only appears if due). Enter:

• Lot #

• ADS 0.5 mL syringe

• Administration Site

Click Complete to record and save.

4

Update Pregnancy Details

Scroll to Pregnancy History and complete or update gravida, parity, and relevant details. Select Complete when finished.

5

Adverse Event (Optional)

If an Adverse Event Following Immunization (AEFI) occurs, use Add → Adverse Event Following Immunization (AEFI) to record details.

6

Save, Return, or End

Use Save anytime to persist progress, or Return to Waiting Room if the patient requires other services.

Best Practice: Saving and Security

Save Early, Save Often

• Save preserves all actions recorded so far.

• Use it whenever stepping away from the tablet (e.g., to weigh another client or check stock).

• If the patient remains in the same room, Save helps prevent data loss due to timeout or logout.

Leaving the Tablet

1. Press Save.

2. Lock the tablet (power button).

This prevents leaving patient data visible or editable on an unattended screen.

7

End the Visit

When all documentation is complete, select End Visit.

In the End Visit / Discharge window:

• Verify the performed actions are checked

• Choose a Discharge Reason (e.g., Discharged to home or self-care – routine discharge)

• Click End Visit

8

Review Upcoming Schedule

After ending the visit, a confirmation appears for upcoming carepath events. Click OK to return to the updated schedule.

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Linkage to the Pediatric DT Schedule

The ANC Td schedule is calculated using DT/TD doses from childhood and adolescence, ensuring lifetime tetanus protection.

Previous DT/TD History	ANC Td During Pregnancy
0 doses	Td1, Td2, Td3 (if timing allows)
1–2 doses	Td1, Td2
3–4 doses	Td1 (single booster)
≥5 doses (fully vaccinated)	None required

The ANC protocol verifies the client’s vaccination record against childhood DT and school-age boosters to determine the remaining doses required for full protection (five valid tetanus-containing doses in total).

For more detail on early immunizations: See the Healthy Baby / Child Carepath page, which includes the DT Pediatric Schedule.

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