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N.C.Department of Environment,Health,and Natural Resources Page 10 -of 11 <br /> Division of General Services FY L7-98 <br /> CONTRACT ADDENDUM <br /> DMCHIWHS/Maternal Health 98 51010 068 <br /> Office,Section,or Branch Contract Number <br /> Orame Maternal Health <br /> Contractor <br /> Activity <br /> SE(MON T): OTTALTTY ACSTTRAN('F,T)FT.TVFRABT FS (Sontirni <br /> (o) <br /> trimester Sgnng or lam 4it(culture) on the initial visit and repeated in the third <br /> (p) Screening for AFP at 16-18 weeks with consent, or documented in the chart that patient <br /> enrolled after 18 weeks into services or was refused by the client. <br /> (q) Screening at initial visit for Blogd Group Rh Determination, and Antibody Screen (repeated as <br /> indicated). Antibody Titer will be done if positive Antibody Screen and repeated as indicated. <br /> (r) Screening at initial visit for Rubella immune Status, unless documented in patient's record vaccine <br /> or previous laboratory test indicating immunity. <br /> (s) Pap smear,limitunless last documented i t pap smear was done within last six months and judged within <br /> (t) Urine Dipstick at each visit. <br /> (u) Quantitative Urine Culture will be done at initial visit, and repeated if needed. <br /> (v) Hgb/Hct. screening each trimester. <br /> (w) Screening at 26-28 weeks for Diabetes with 50 g. glucose and OGTT if indicated. <br /> (x) Screenin if indicated for H b electrophoresis with informed consent documented in the chart, or <br /> documented refusal by the client. <br /> (y) Prenatal Education wiII include docmentation in the record of <br /> 1. All patients will receive individual education about their identified risk conditions(s) <br /> 2. B��ssio prenatal education may be provided in an individual or group format and provision <br /> of this education must be clearly documented in the medical record. Any appropriately <br /> trained members of the maternal health team can provide the education component$. <br /> These�ncludeNurse Nutritionist, Social Worker, MCC,MD, CNM, Nurse?ractitigner, <br /> Physician Assistant, Health Educator, etc. For example, if the MCC or the nutritionist <br /> provides education n a given topic, this education need not be repeated by another <br /> member orr the health team. <br /> (a) Required educational components <br /> 1. First trimester; <br /> • nutrition/weight gain <br /> • over-the-counter medications <br /> • substance abuse <br /> • bleeding <br /> • severe headaches <br /> • visual changes <br /> DEHNR 3300(Revised 2/90) eviewed by <br /> General Services Division(Review 1/95) <br />