RECOMMENDATIONS FOR ALL TEAMS

• Please notify Kristy and Moises about the specialists that will be joining your team as soon as possible. This way, we can arrange teaching or meetings with our staff to promote good relationships and further education of our staff and yours.
• Prior to the first medical clinic, all people who will be taking blood pressures should be trained and ready to begin when we arrive at the batey.  Training of how to take blood pressures should not happen at the batey clinic due to noise and pressure to begin the clinic.
• Before leaving the dormitory each morning, someone from the team should check all of the needed bins that have been loaded to verify that ALL medications and supplies have been loaded onto the bus that need to be at the clinic.  This includes the de-worming medicine and the dental supply bin as well as a scale.  Please place someone from your group in charge of this.
• If you run out of a medication or supply, you need to notify Kristy or Junior at least one day before you need the medication or supply.  This includes de-worming medicine.  Late notification of needs may prevent you from having the medicine that you want in the clinic.  For medications that you will be purchasing in the Dominican Republic, the hospital needs notification 2 weeks in advance.
  
• Scrubs, pants or skirts will be worn by all team members at the medical clinic to promote professionalism.  No shorts are allowed.  T-shirts rather than tank tops are encouraged.  If you will be outside with the de-worming medication or children's activities, you should wear a hat and use sunscreen.
• If you are outside of the clinic and find a patient that needs to be consulted, please approach Kristy or Junior to follow the proper procedures for a consultation.
• Referrals can be made from the batey medical clinic for further testing or follow-up.  The team that refers a patient is expected to financially help a patient that they are ADMITTING to the Good Samaritan Hospital but it is their discretion whether they decide to financially help patients with general referrals for testing or follow-up.  A general referral form should be completed and given to the patient.  These referral forms should be brought with the team. This form is provided on the website, http://laromanadreamin.tripod.com so that copies can be made before arriving to the Dominican Republic.
• Individual financial help that team members want to provide for a patient should be discussed with Kristy, Junior or Moises.  There are certain processes that need to be followed to determine if this is an appropriate option or not.  Please trust the decisions that the hospital makes about the appropriateness of financial help.  If you have a member of your team that is very interested in helping the poor financially, the hospital ALWAYS needs financial support for indigent patients who come to the hospital needing care and a donation can be made to this program.
  
• Translators or staff that want/need medication should have a regular consult with a card so that  a record of what medications were given is kept.  Medications that someone wants for their family or friends must be ok'd by Kristy or the leader of the medical clinic when Kristy is not there to prevent misuse or running out of needed medications for the bateyes.
• A Dominican physician will be present in each medical clinic.  This is a required protocol for the hospital and is considered a required expense for the team.  Please utilize this physician when there are questions about tropical medicine or local procedures.  No team will be allowed to run a medical clinic without proper medical supervision.  Student medical/nursing teams that wish to participate in consultations must have at least one medical/nursing instructor who is responsible for the actions of the team members and responsible for educating them on medication use and diagnosis.  Kristy, when on-site, is also available for consultation but will be out of the country for most of 2009 and early 2010.
• Consultation cards will be provided by the hospital although some teams do also provide printed cards and these are much appreciated!  The cards should follow the SOAP format and all cards should include a diagnosis even if the diagnosis is: "Healthy female."  This will help the pharmacy to confirm the use of specific medications and know what substitutions may be possible if needed.  Prescriptions should be written in the following way:  Name of medication, mg, dose, frequency, the number of days that the medication will be given and the amount of medication given.  Ex:  Ibuprofen (200mg), 1-2 pills, TID x 10 days as needed, #30.
• Translators will be provided for all persons (non-Spanish speaking) consulting patients as well as 2 people for the pharmacy, one at the entrance of the clinic and 2 at the intake table.  Please be prepared for this cost.  Volunteers are also present in the clinic.  For verification who is a translator and who is a volunteer, please talk to Junior who is the head of the translators.
• Please utilize the translators for information regarding culture, protocol and clarification of what patients are saying.  There are many phrases that the direct translation of does not make any sense in English so a translator may not give you a direct translation but rather an "interpretation" of what was said.  Any concerns regarding the proficiency or accuracy of your translator should be discussed with Junior.  Please understand that some translators have been working longer than others and may be more proficient so it is not wrong to express your concerns and may actually benefit the translator so that they know where they need to work on their English.  If you have a translator that has done a good job, please let him/her know as well as Junior.  This is definitely encouraging for them!