General / Primary Care Visit – Adult Injury & Td Booster

Purpose

The General / Primary Care Visit module is used when a patient presents for general clinical care. In this example, the visit documents an adult with a minor injury requiring a Td booster immunization.

This workflow shows how to:

  • Search and open a patient record

  • Start a General / Primary Care Visit

  • Review demographics and conditions

  • Record Td booster administration (performed now or back-entered)

  • Discharge the patient after care is completed

Navigation

From the sidebar, expand Patients and select Search.

  • Search for the patient using one or more identifiers.

  • Open the View Patient page.

  • Select Start Visit.

Workflow

1

Open the patient record from the Patients → Search menu, review demographics, then select Start Visit.

When prompted, choose the visit template:

  • Select General / Primary Care Visit.

2

Review Active Conditions (e.g., pregnancy, HIV status). Update or add new conditions if relevant.

3

For a General / Primary Care Visit, the following appear pre-populated under Performing Today:

  • Td (Adult)

  • HIV Status

Review these services and update details as required (e.g., Lot #, Syringe Type, Administration Site).

4

Finalize the immunization entry using one of the following methods:

  • Select Performing Today.

  • Enter:

    • Lot #

    • Syringe Type (ADS 0.5 mL)

    • Administration Site

  • Click Complete to record the dose.

5

Use Save to keep the visit open if more services are needed. Select Return to Waiting Room if the patient is awaiting additional care.

  • Options: Checked In, Awaiting Specialist Care, Awaiting IMCI Care, Awaiting Vaccination.

Best Practice: Saving and Security

Save Early, Save Often

  • The Save button persists the actions completed so far.

  • Use it whenever stepping away from the tablet (e.g., to answer a phone call, check stock, or step out briefly).

  • If the patient is not being moved to another room/waiting area, use Save to avoid losing data due to timeout or logout.

Leaving the Tablet If you need to leave your tablet unattended:

  1. Press Save on the visit.

  2. Lock the tablet by pressing the power button.

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

6

When Td booster has been administered, select End Visit.

  • Confirm the immunization action is checked.

  • Select a Discharge Reason (commonly Discharged to home or self care – routine discharge).

  • Complete the discharge.

Key Notes

  • This workflow applies to adult General / Primary Care Visits such as wound management or injury follow-up where a Td booster is required.

  • Syringe Type (ADS 0.5 mL) must always be recorded with the immunization.

  • HIV Status and Td (Adult) are pre-populated services for this visit type — they do not need to be manually added.

  • Different visit types may have other services pre-populated.

  • Back-entry ensures historical doses are documented correctly.

  • Patients can be safely returned to the Waiting Room for additional services.

  • Always confirm the discharge reason to finalize the encounter.

Other Services You Can Add

During a General / Primary Care Visit, the following additional services can also be recorded:

  • Supplements (e.g., Vitamin A, Iron/Folic Acid)

  • Weight and Height Entry (growth or BMI monitoring)

  • Pregnancy Status

  • Adverse Event Following Immunization (AEFI)

  • Developmental Disability

  • Death Report

  • Routine Childhood or Adult Immunizations

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