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Table 4 Observer reported errors and difficulties by CHW group (not listed by frequency)

From: Improving community health worker use of malaria rapid diagnostic tests in Zambia: package instructions, job aid and job aid-plus-training

Test category and steps Manufacturer's instructions Job aid-only Job aid plus training
Preparation and documentation    
1. Assembles materials
2. Removes contents from test packet
3. Records patient's name on cassette
4. Selects 4th finger of left hand, cleans it with alcohol swab, allows it to dry
5. Records test results in CHW register
- Did not record test results
- Recorded results prior to completion of test
- Difficulty identifying test packet contents and their use
- Difficulty understanding instructions
- Prepared incorrect finger
- Lacked CHW register
- Prepared incorrect finger
- Lacked CHW register
- Did not assemble contents prior to test
RDT Use    
1. Checks expiration date to make sure test is still valid
2. Collects film of blood with enclosed loop making sure to fill the loop
3. Using the loop, blots blood on the pad in sample well A
4. Dispenses six drops of clearing buffer into well B
5. Waits 15 minutes before reading results
- Difficulty drawing adequate quantity of blood
- Difficulty using loop for collection of blood
- Transferred blood to incorrect well
- Omitted use of buffer
- Omitted use of loop
- Collected blood with lancet
- Used alcohol as buffer
- Used alcohol swab to collect and transfer blood
- Left swab or other materials in test well
- Did not monitor time
- Waited > 15 minutes prior to reading results
- Did not check test expiry date
- Difficulty drawing adequate quantity of blood
- Difficulty using loop for collection of blood
- Transferred blood in incorrect well
- Dispensed buffer prior to placing blood
- Did not monitor time
- Did not check test expiry date
- Difficulty drawing adequate quantity of blood
- Difficulty using loop for collection of blood
- Waited > 15 minutes
- Did not check test expiry date
Safe handling and disposal    
1. Puts on new gloves
2. Uses sterile lancet to prick finger
3. Discards lancet in sharps bin immediately after pricking
4. Discards loop in the sharps bin immediately after transferring blood to test cassette
5. Disposes of gloves, wrappers, alcohol swab, loop, desiccant, and cassette in non-sharps bin
- Omitted cleaning finger prior to pricking
- Punctured finger multiple times
- Lancet set down on table and re-used on same patient
- Incorrect disposal of items in sharps vs. non-sharps container
- Near use of same pair of gloves on new patient
- Near use of same RDT on new patient
- Punctured finger multiple times
- Lancet set down on table and re-used on same patient
- Incorrect disposal of items in sharps vs. non-sharps container
- Near use of same pair of gloves on new patient
- Punctured finger multiple times
- Incorrect disposal of items in sharps vs. non-sharps container