How Do We Define Adherence? Improving Adherence to TB Treatment. Broad View of Adherence. What is adherence?
|
|
- Edward Tucker
- 5 years ago
- Views:
Transcription
1 How Do We Define Adherence? Improving Adherence to TB Treatment Lillian Pirog, RN, PNP Nurse Manager, Waymon C. Lattimore Practice NJMS Global Tuberculosis Institute What is adherence? A. Taking medication consistently B. Keeping clinic appointments C. Reporting for DOT D. Meeting a minimum percent for medications taken What is adherence? Broad View of Adherence Adherence to treatment means that a patient is following the recommended course of treatment by taking all prescribed medications and coming for scheduled exams and tests. Recognizes that adherence is not only about taking medication Actively engages patients in health care and treatment Adherence (or patient-centered compliance) refers to the involvement of patients working with health care providers in managing their treatment ** Adherence is preferred to compliance it portrays a more respectful and active role of the patient in disease management** ** Bulletin of the World Health Organization, Vol. 86 (No. 3)
2 Problems With Adherence To TB Medication Are Common Reasons for Non-Adherence to HIV Medications Simply forgot or busy (66%) Non adherence to medications: 20% to 80% (avg. of 50%) Rates comparable to treatments for other chronic diseases Williams & Friedland, 1997; Chesney, 2000; Eldin, Away from home (57%) Change in daily routine (51%) Fell asleep (40%) Illness (28%) Depression (18%) Privacy concerns (14%) Side Effects (12%) Bamberger, 2000 Reasons for TB non-adherence What is the most common reason patients where you work do not take their medications: A. Patients feel better B. Lack of understanding of treatment regimen C. Access to care D. Language barriers E. Lack of motivation F. Other health problems Reasons for Non-Adherence Patients feel better Lack of knowledge or understanding of treatment regimen Personal or cultural beliefs Lack of skills or resources Lack of access to care Language barriers Poor relationships with health care provider(s) Lack of motivation 2
3 Responsibility The patient is responsible for his/her adherence? A. True B. False 2003 TB Treatment Guidelines The healthcare provider is responsible for successful treatment, not the patient Prescribing appropriate regimen Ensuring successful completion of therapy Focus on patient-centered care utilizing case management and directly observed therapy (DOT) Case Management System is patient focused and involves: Assignment of responsibility Systematic review of patient progress Adherence plan Continuity of care Case manager should ensure: Treatment plan is established Patient is educated Therapy and follow-up are continuous Contacts are examined Provider-Patient Relationship Provide accurate, current TB health information Anticipated side-effects and management When and how to contact provider Communicate goals of medical care Reasonable and acceptable for patient Small steps over time Put it all on the table (no hidden agendas) Consequences of failing to adhere Anticipate and address other medical or lifestyle issues Ask about non-medical issues Support mechanisms and advocates 3
4 Promoting Adherence Directly Observed Therapy (DOT) The microbe is nothing...the terrain everything -- Louis Pasteur Terrain = circumstances surrounding each pt that may affect ability to complete Tx Effective TB case management + DOT identifies and characterizes terrain Adherence can be facilitated by positive or negative attributes related to health system, social/family issues, personal factors and drug factors (e.g., medication sideeffects are negative drug attributes) ** Involves providing anti-tb drugs directly to patient and watching as patient swallows each dose Preferred strategy for all patients with TB Consider for all patients Should be used for all intermittent therapy Can lead to reductions in relapse and acquired drug resistance ** Bulletin of the World Health Organization, Vol. 86 (No. 3) DOT Priority If you had to prioritize DOT for TB patients, who would be your highest priority: A. Patient with inactive, prior TB disease B. 6-year-old child on treatment for LTBI (no known source case) C. Adult contact to MDR-TB case with positive TST result and normal chest x-ray D. Patient with HIV and lymphatic TB Prioritizing for DOT Pulmonary TB with + sputum smears Past treatment failure Exposure to drug resistant case Case of relapse Co-infected with HIV Current or prior substance use issues, psychiatric illness, memory impairment Non-adherence to therapy Children and adolescents Close contacts of case of TB disease Immunocompromised MMWR, June 20,2003 4
5 Interventions for Adherence Many different types of interventions Can be tailored to address specific challenges patient may face Best approach is multi-level strategy that addresses: Patient Regimen Provider Meet Patients at Their Level Patient-Focused Interventions Individualize based on patient s knowledge, attitudes, and beliefs about TB Provide education and information Use interpreters, when possible Medication scheduling and cues (e.g., at meal times or when brushing teeth, etc.) Adherence gadgets (e.g., pill boxes, timers, etc.) 5
6 Regimen-Focused Interventions Manage side effects Reduce pill burden Dietary interventions Provide medication fact sheets Provide dosing instruction sheets Utilize tricks of the trade Peer support Pain management (e.g., parenteral administration) Tricks of the Trade For babies & young children, pills can be crushed & dissolved in a teaspoon of water 4 This can then be mixed with a small amount of food such as apple sauce, mashed bananas, yogurt, etc. Provider-Focused Interventions Multi-disciplinary team with knowledge of TB management Adherence-related policies or protocols Prompt and frequent follow-up Medical advocacy Contracting between patient and provider Active patient role Progressive Interventions for Nonadherent Patients Advise patient on importance of adherence, consequences of failure to adhere, & possible implications (involuntary confinement) for nonadherence to TB treatment Learn the reasons for non-adherence Address identified problems of nonadherence (incentives, enablers) (DOT if not already on DOT) DOT agreement form Home isolation form Adherence Completion of OR treatment Voluntary orders Non-adherence Court-ordered DOT Adherence Completion of (optional) treatment Non-adherence Court-ordered involuntary isolation/confinement for inpatient treatment 6
7 Incentives & Enablers Incentives Small rewards given to patients to encourage them to adhere to treatment or keep appointments Enablers Things that make it possible or easier to receive treatment Both should be appropriate and valued by the patient Find sources of both (e.g., ALA, community groups, local stores, volunteers) Incentives Examples Enablers Washington State TB Services Manual Background (1) Case Study 32 y/o Ethiopian female diagnosed with pansensitive TB at a local hospital in NY Contact investigation identified 5 high-priority contacts residing in NJ One of the contacts is a 3 year old male 7
8 Background (2) Field visit made to family of the 3 year old contact Several attempts were made to have child skin tested Finally staff were able to arrange TST in field after clinic hours Background (3) TST results 5 positive, 1 negative 3 year old 12 mm CXR and medical evaluation 5 x-rays negative 3 year old male abnormal X-ray consistent with TB Background (4) 3 y/o seen by private pediatrician Diagnosed with suspected pulmonary/tb meningitis Treatment initiated with I, R, Z (DOT) Admitted to local hospital next day with c/o fever, cough, wt. loss, poor appetite, headache, stomach pain, listlessness, vomiting EMB added to existing regimen Cerebrospinal fluid smear negative Culture positive for M. tb Sensitive to R,I,P,E,S Background (5) MRI findings consistent with TB meningitis Gastric aspirate smear/culture negative Repeat CXR abnormal/no change Discharged from hospital and referred for outpatient care DOT initiated next day following hospital discharge 8
9 Concerns & Challenges Time & scheduling conflicts Language barrier Psychosocial aspects of TB diagnosis Difficulty administering medication Complaints of abdominal discomfort Spits out meds/sometimes vomits or gags Family member interference Attempted Resolution Arranged for DOT outside of regular clinic hours Solved scheduling conflict Arranged for father to be present for DOT Solved issues of language barriers Solved issues of interference from grandmother Used creative techniques to administer medication Peanut butter and grape juice Blow pops/magic tricks Twin brother pretended to be medicated also Outcomes to Date Using tricks of the trade was successful Patient playful/animated Completed one year of treatment with 100% DOT adherence Lessons Learned Importance of: Providing services outside clinic hours Reassuring parents that TB is treatable and curable The key to success Flexibility Patience Coordination Cooperation Persistence 9
10 Take-Home Points After this talk what change will you most likely implement: A. Use incentives/enablers B. Explore changing of dosing to patient convenience C. Implement case management system Individualize treatment plans to each patient s needs Recognize specific challenges of working with TB Use knowledge and tools to overcome challenges and to advocate for patients Carefully monitor for treatment failure even with DOT Explore opportunities to link with providers across disciplines to strengthen adherence support D. Change how DOT is implemented Other Summary Before. DOT + individualized case management + enablers/incentives = Best Treatment Results 10
11 After. 11
Tricks of the Trade: Strategies for Pediatric TB Case Management
Tricks of the Trade: Strategies for Pediatric TB Case Management Lillian Pirog, RN, BSN, PNP Nurse Manager, Global Tuberculosis Institute Suzanne Tortoriello, RN, MSN, APN Advanced Practice Nurse, Global
More informationAdministrative Without, TB control fails. TB Infection Control What s New? Early disease prevention Modern cough etiquette
Early disease prevention Modern cough etiquette TB Infection Control What s New? Mark Lobato, MD Division of TB Elimination CDC TB Intensive Workshop Global TB Institute, Newark, NJ September 16, 2010
More informationOverview: TB Case Management and Contact Investigation
Overview: TB Case Management and Contact Investigation Karen A Martinek, RN, MPH Alaska DHSS, DPH, Section of Epidemiology Overview Define tuberculosis (TB) case management Describe the roles and responsibilities
More informationDirectly Observed Therapy for Active TB Disease and Latent TB Infection
Directly Observed Therapy for Active TB Disease and Latent TB Infection Policy Number TB-5001 Effective Date (original issue) September 6, 1995 Revision Date (most recent) June 26, 2008 Subject Matter
More informationPractical Aspects of TB Infection Control
Practical Aspects of TB Infection Control Sundari Mase, MD Division of TB Elimination, CDC TB Intensive Workshop October 1, 2014 National Center for HIV/AIDS, Viral Hepatitis, STD & TB Prevention Division
More informationFundamentals of Nursing Case Management
Fundamentals of Nursing Case Management Shea Rabley, RN, MN TB Nurse Educator Mayo Clinic Center for Tuberculosis 2014 MFMER slide-1 Disclosures No relevant financial relationships No off-label investigational
More informationTB Elimination. Respiratory Protection in Health-Care Settings
TB Elimination Respiratory Protection in Health-Care Settings Introduction All health-care settings need an infection-control program designed to ensure prompt detection, airborne precautions, and treatment
More informationTuberculosis Prevention and Control Protocol, 2018
Ministry of Health and Long-Term Care Tuberculosis Prevention and Control Protocol, 2018 Population and Public Health Division, Ministry of Health and Long-Term Care Effective: January 1, 2018 or upon
More informationPublic Health/Primary Care Collaboration: Success Strategies in Denver
Public Health/Primary Care Collaboration: Success Strategies in Denver Randall Reves, M.D., M.Sc. Carolyn Bargman, R.N.-C., M.A. Denver Metro Tuberculosis Control Program Denver Public Health Department
More informationNICU CI. Tools For TB Elimination April 22, 2015 Curry International Tuberculosis Center. CI in Healthcare Facilities 1. Case Summary.
NICU CI Michael Stacey MD, MPH CMO/Dep Health Officer/TB Controller Solano County Public Health Case Summary Index Case: Pregnant 34 yo Filipino descent sent to Sacramento County hospital from a Solano
More informationManagement of patients with TB/HIV Gunta Kirvelaite
Management of patients with TB/HIV Gunta Kirvelaite Riga East Clinical hospital, Centre for tuberculosis and lung diseases. Head of outpatient department. MDR TB physician. WHO Collaborating Centre for
More informationPrevent the transmission of tuberculosis (TB) and cure individuals with active TB disease
Tuberculosis (TB) Control and Prevention Program Program Purpose PHD/CHPB Evelyn Poppell, x5600 Rachel Kidanne, x5605 Prevent the transmission of tuberculosis (TB) and cure individuals with active TB disease
More informationCommunicable Disease Control Manual Chapter 4: Tuberculosis
Provincial TB Services 655 West 12th Avenue Vancouver, BC V5Z 4R4 www.bccdc.ca Communicable Disease Control Manual July, 2018 Page 1 TABLE OF CONTENTS APPENDIX B: INFECTION PREVENTION AND CONTROL... 2
More informationTUBERCULOSIS TABLE OF CONTENTS TUBERCULOSIS CONTROL PLAN...2 ADMISSIONS...3 PROSPECTIVE EMPLOYEES...5
TUBERCULOSIS TABLE OF CONTENTS TUBERCULOSIS CONTROL PLAN...2 ADMISSIONS...3 PROSPECTIVE EMPLOYEES...5 ANNUAL PERSONNEL SCREENING...5 EXPOSURE INCIDENTS...5 DOCUMENTATION OF OCCUPATIONAL EXPOSURE...5 PRE-PLACEMENT
More informationCatalina Navarro, RN, BSN March 17, TB Nurse Case Management March 17 19, 2015 San Antonio, Texas
Principles of TB Nurse Case Management: Why are We Here? Catalina Navarro, RN, BSN March 17, 2015 TB Nurse Case Management March 17 19, 2015 San Antonio, Texas EXCELLENCE EXPERTISE INNOVATION Catalina
More informationThe Role of Public Health in the Management of Tuberculosis
The Role of Public Health in the Management of Tuberculosis Lorna Will, RN, MA TB Nurse Consultant Wisconsin TB Program Ann Steele, RN Public Health Nurse Appleton Health Dept November 2016 2014 MFMER
More informationSTANDARDS OF CARE HIV AMBULATORY OUTPATIENT MEDICAL CARE STANDARDS I. DEFINITION OF SERVICES
S OF CARE Oakland Transitional Grant Area Care and Treatment Services J ANUARY 2007 Office of AIDS Administration 1000 Broadway, Suite 310 Oakland, CA 94612 Tel: 510. 268.7630 Fax: 510.268-7631 AREAS OF
More information902 KAR 20:200. Tuberculosis (TB) testing for residents in long-term care settings.
0 KAR :0. Tuberculosis (TB) testing for residents in long-term care settings. The final version was copied on April, from the Kentucky Legislative Commission Website, http://www.lrc.ky.gov/kar/0/0/0.htm.
More informationPartnerships for Success: Laboratories and Programs Meeting the Challenge. Partnerships During a TB Outbreak
Partnerships for Success: Laboratories and Programs Meeting the Challenge Partnerships During a TB Outbreak 2015 National TB Conference Atlanta, GA David Warshauer, PhD., D(ABMM), Deputy Director, Communicable
More informationFAST. A Tuberculosis Infection Control Strategy. cough
FAST A Tuberculosis Infection Control Strategy FIRST EDITION: MARCH 2013 This handbook is made possible by the support of the American people through the United States Agency for International Development
More informationFlorida Tuberculosis System of Care
Table of Contents I. Introduction... 4 II. Florida s Charge... 5 III. Florida Tuberculosis System of Care... 5 IV. Florida Department of Health Tuberculosis Program... 7 V. Florida Department of Health
More informationNumber: Ratio of the airflow to the space volume per unit time, usually expressed as the number of air changes per hour.
POLICIES & PROCEDURES Number: 40 175 Title: Tuberculosis (TB) Management Program Authorization: [X] SHR Infection Control Committee [ ] Facility Board of Directors Source: Infection Prevention & Control
More informationPrevent the transmission of tuberculosis (TB) and cure individuals with active TB disease
Tuberculosis (TB) Control and Prevention Program Program Purpose Program Information PHD/CHPB Evelyn Poppell, x5600 Nga Nguyen, x5663 Prevent the transmission of tuberculosis (TB) and cure individuals
More informationTUBERCULOSIS INFECTION CONTROL PROGRAM
TUBERCULOSIS INFECTION CONTROL PROGRAM TB Infection Control Program for (Health Department Name) I. Assignment of Responsibility. A. (PersonIPosition) has overall responsibility for TB infection control
More informationStrategy of TB laboratories for TB Control Program in Developing Countries
Strategy of TB laboratories for TB Control Program in Developing Countries Borann SAR, MD, PhD, Institut Pasteur du Cambodge Phnom Penh, Cambodia TB Control Program Structure of TB Control Establish the
More informationCase Study of a Non-compliant TB Patient
Case Study of a Non-compliant TB Patient DENEEN GALLAGHER RN, BSN INGHAM COUNTY HEALTH DEPARTMENT MDCH TB NURSE CERTIFICATION COURSE JULY 24, 2014 Case History 21 year old male from Honduras Known exposure
More informationCASE MANAGEMENT POLICY
CASE MANAGEMENT POLICY Subject: Acuity Scale Determination Effective Date: March 21, 1996 Revised: October 25, 2007 Page 1 of 1 PURPOSE: To set a minimum standard across Cooperative agencies regarding
More informationSESSION 1: INTRODUCTION TO DOT
FRANCIS J. CURRY NATIONAL TUBERCULOSIS CENTER SESSION 1: INTRODUCTION TO DOT INTRODUCTION In this 2-hour session, participants will learn the current scope of TB in the United States and in their own states
More informationRose Barrajas, RN September 12, TB Nurse Case Management September 12 14, 2017
Principles of TB Nurse Case Management Rose Barrajas, RN September 12, 2017 TB Nurse Case Management September 12 14, 2017 EXCELLENCE EXPERTISE INNOVATION Rose Barrajas, RN has the following disclosures
More informationKentucky TB Prevention & Control Program. Special Edition
Kentucky TB Prevention & Control Program Welcome... To our Special Edition 2016. - Kentucky TB Program staff Special Edition In this issue TB Regulations: Highlights p.1 Fact Sheet: LTC Regulation p.2-4
More informationStaffing Your TB Program
TB Program Management San Antonio, Texas November 5-7, 2008 Staffing Your TB Program Lynelle Phillips, RN, MPH November 6, 2008 Staffing Your TB Program Lynelle Phillips RN MPH Program Manager s Course
More informationNew Jersey Administrative Code Department of Health and Senior Services Title 8, Chapter 57, Communicable Disease
New Jersey Administrative Code Department of Health and Senior Services Title 8, Chapter 57, Communicable Disease SUBCHAPTER 5: MANAGEMENT OF TUBERCULOSIS 8:57-5.1: Purpose and Scope The principle purpose
More informationTuberculosis Case Management for Removable Alien Inmates/Detainees in Federal Custody
Background Tuberculosis Case Management for Removable Alien Inmates/Detainees in Federal Custody Federal Bureau of Prisons (Department of Justice) United States Marshals Service (Department of Justice)
More informationTB PATIENT MANAGEMENT PROJECT BUSINESS USE CASE SPECIFICATION 108: LEGAL ACTION
TB PATIENT MANAGEMENT PROJECT BUSINESS USE CASE SPECIFICATION 108: LEGAL ACTION Version 1.0 02/23/2004 This document has been developed by Science Applications International Corporation (SAIC) under a
More informationTuberculosis (TB) Procedure
Tuberculosis (TB) Procedure (IPC Manual) DOCUMENT CONTROL: Version: 1 Ratified by: Clinical Policies Review and Approval Group Date ratified: 4 September 2018 Name of originator/author: RDaSH Community
More informationHello. Welcome to this webinar titled Preventing and Controlling Tuberculosis in Correctional Settings.
Hello. Welcome to this webinar titled Preventing and Controlling Tuberculosis in Correctional Settings. This webinar was produced by the Minnesota Department of Health Tuberculosis Program. This is the
More informationCDPH - CTCA Joint Guidelines Guidelines for the Follow-Up and Assessment of Persons with Class A/B Tuberculosis
CDPH - CTCA Joint Guidelines Guidelines for the Follow-Up and Assessment of Persons with Class A/B Tuberculosis These guidelines are intended to be used as an educational aid to help clinicians make informed
More informationWHO policy on TB infection control in health care facilities, congregate settings and households.
WHO policy on TB infection control in health care facilities, congregate settings and households. Rose Pray Stop TB, WHO Why should we develop a policy on TB infection control? To guide countries on what
More informationTuberculosis: Surveillance and the Health Care Worker
Tuberculosis: Surveillance and the Health Care Jo Fagan Director Public Health PHAC Delivering a Healthy WA Overview 1. Pre-employment assessment 2. Post-exposure follow-up 3. Routine follow up testing
More informationEngaging the Private Retail Pharmaceutical Sector in TB Case Finding in Tanzania: Pilot Dissemination Meeting Report
Engaging the Private Retail Pharmaceutical Sector in TB Case Finding in Tanzania: Pilot Dissemination Meeting Report February 2014 Engaging the Private Retail Pharmaceutical Sector in TB Case Finding
More informationStage 2 GP longitudinal placement learning outcomes
Faculty of Life Sciences and Medicine Department of Primary Care & Public Health Sciences Stage 2 GP longitudinal placement learning outcomes Description This block focuses on how people and their health
More informationDirectly Observed Therapy and Case Studies Bridget Konz, RN September 28, 2011
TB Nurse Case Management Davenport, Iowa September 27 28, 2011 Directly Observed Therapy and Case Studies Bridget Konz, RN September 28, 2011 Bridget Konz, RN has the following disclosures to make: No
More informationTEENAGE VOLUNTEER (TAV) APPLICATION FORM
Leesburg Regional Medical Center, 600 East Dixie Avenue, Leesburg, FL 34748 (Phone: 352.323.5060) Please return completed application to the hospital or email to: jwoods@centflhealth.org TEENAGE VOLUNTEER
More informationPhilippine Strategic TB Elimination Plan: Phase 1 (PhilSTEP1)
2017 2022 Philippine Strategic TB Elimination Plan: Phase 1 (PhilSTEP1) 24 th PhilCAT Convention August 16, 2017 Dr. Anna Marie Celina Garfin NTP-DCPB, Department of Health Reasons for developing the NTP
More informationCommunity Health Services in Bristol Community Learning Disabilities Team
Community Health Services in Bristol 2014 Community Learning Disabilities Team This provides specialist community based services for adults with learning difficulties and help to promote equal access to
More informationTB INTENSIVE WORKSHOP
TB INTENSIVE WORKSHOP SEPTEMBER 13-16, 2011 CNE/CME CERTIFIED ACTIVITY FACULTY www.umdnj.edu/globaltb Boston University School of Medicine Boston, MA John Bernardo, MD Professor of Medicine & Research
More informationPediatric Neonatology Sub I
Course Goals Goals 1. Provide patient care that is compassionate, appropriate and effective for the treatment of health problems. 2. Recommend and interpret common diagnostic tests and vital signs. 3.
More informationPROJECT GRANTS AND COOPERATIVE AGREEMENTS FOR TUBERCULOSIS CONTROL PROGRAMS TUBERCULOSIS CONTROL PROGRAMS
APRIL 2011 93.116 PROJECT GRANTS AND COOPERATIVE AGREEMENTS FOR TUBERCULOSIS CONTROL State Project/Program: PROJECT GRANTS AND COOPERATIVE AGREEMENTS FOR TUBERCULOSIS CONTROL Federal Authorization: U.
More informationMENTAL HEALTH NURSING ORIENTATION. (2) Alleviating disabling symptoms of mental disorders.
Page 1 of 6 1. Mission Statement MENTAL HEALTH NURSING ORIENTATION a. The mission of mental health services is to provide constitutionally adequate care. Mental health care is provided to assist the inmate
More informationTB PREVENTION AND CONTROL: WORKING WITH THE HOMELESS
CASE MANAGEMENT AND CONTACT INVESTIGATION INTENSIVE TB PREVENTION AND CONTROL: WORKING WITH THE HOMELESS OBJECTIVES Upon completion of this session, participants will be able to: 1. Explain the responsibilities
More informationPatient Rights and Responsibilities
Developed / Edited By: UNION HOSPITAL Reviewed By: Approved By: Policy Number: AG-245 Elkton, Maryland Effective Date: 11/2009 Hospital Policies and Procedures Patient Rights and Responsibilities Departments
More informationFacility Tuberculosis (TB) Risk Assessment for Correctional Facilities
Facility Tuberculosis (TB) Risk Assessment for Correctional Facilities The various areas within correctional facilities have different levels of risk for TB transmission. Apply this worksheet to assess
More informationTest Content Outline Effective Date: February 9, Pediatric Primary Care Nurse Practitioner Board Certification Examination
Board Certification Examination There are 200 questions on this examination. Of these, 175 are scored questions and 25 are pretest questions that are not scored. Pretest questions are used to determine
More informationAssertive Community Treatment (ACT)
Assertive Community Treatment (ACT) Assertive Community Treatment (ACT) services are therapeutic interventions that address the functional problems of individuals who have the most complex and/or pervasive
More informationPain: Facility Assessment Checklists
Pain: Facility Assessment Checklists This is a series of self-assessment checklists for nursing home staff to use to assess processes related to pain management in the facility, in order to identify areas
More informationTB: non-adherence, why it s a problem, and what to do about it. Elizabeth Rea, MD, MSc, FRCPC AMOH, TB program Toronto Public Health
TB: non-adherence, why it s a problem, and what to do about it Elizabeth Rea, MD, MSc, FRCPC AMOH, TB program Toronto Public Health March 24 th World TB Day Every TB patient counts Slow-growing bacteria
More informationPain: Facility Assessment Checklists
Pain: Facility Assessment Checklists A facility system assessment is a starting point for a quality improvement project. The checklists included in this booklet will be most useful if you take a critical
More informationHematology and Oncology Curriculum
Hematology and Oncology Curriculum Program overview The University of Texas Southwestern Medical Center provides a three year combined Hematology/Oncology fellowship training program in which is administered
More informationInitiating a Contact Investigation
Initiating a Contact Investigation Jessica Quintero, M.Ed. September 14, 2017 TB Nurse Case Management September 12 14, 2017 San Antonio, Texas EXCELLENCE EXPERTISE INNOVATION Jessica Quintero, M.Ed. has
More informationPATIENT SERVICES POLICY AND PROCEDURE MANUAL
SECTION Patient Services Manual Multidiscipline Section NAME Patient Rights and Responsibilities PATIENT SERVICES POLICY AND PROCEDURE MANUAL EFFECTIVE DATE 8-1-11 SUPERSEDES DATE 7-20-10 I. PURPOSE To
More informationInternal Medicine Curriculum Infectious Diseases Rotation
Contact Person: Dr. Stephen Hawkins Internal Medicine Curriculum Infectious Diseases Rotation Educational Purpose The infectious disease rotation is a required rotation primarily available for PGY, 2 and
More informationCorrectional Tuberculosis Screening Plan Instructions
Correctional Tuberculosis Screening Plan Instructions The Correctional Tuberculosis (TB) Screening Plan (Publication # TB-805) is designed for jails and community corrections facilities which meet Texas
More informationTUBERCULOSIS INFECTION CONTROL
OBJECTIVES TUBERCULOSIS INFECTION CONTROL At the end of this presentation, you will be able to: List infection control approaches to TB prevention and control Describe the type of protective equipment
More informationRECUPERATIVE CARE PROGRAM Case Manager Referral Form (TO BE COMPLETED BY SOCIAL SERVICES)
Case Manager Referral Form (TO BE COMPLETED BY SOCIAL SERVICES) PLEASE NOTE: Patient must bring with him/her any needed medications. We share space in facilities that do not allow drug or alcohol use.
More informationINTERNAL MEDICINE RESPIRATORY MEDICINE ROTATION OBJECTIVES
INTERNAL MEDICINE RESPIRATORY MEDICINE ROTATION OBJECTIVES A. The following goals/objectives cover the breadth of respirology for an internal medicine residency. While many objectives may be covered during
More informationChecklists for screening for active tuberculosis in high-risk groups
Checklists for screening for active tuberculosis in high-risk groups General screening program considerations The following are aspects of design and implementation that should be considered before planning
More informationDiana Fortune, RN, BSN has the following disclosures to make:
Community TB Prevention Diana Fortune, RN, BSN Barbarah Martinez, RN, BSN September 23, 2015 TB Nurse Case Management September 22 24, 2015 San Antonio, TX EXCELLENCE EXPERTISE INNOVATION Diana Fortune,
More informationHealthcare Effectiveness Data and Information Set (HEDIS)
Healthcare Effectiveness Data and Information Set (HEDIS) IlliniCare Health is a proud holder of NCQA accreditation as a managed behavioral health organization (MBHO) and prioritizes best in class performance
More informationModule 2: Learning Objectives Module 2: Retention, Adherence, and Psychosocial Support in PMTCT Programs
Module 2: Learning Objectives Module 2: Retention, Adherence, and Psychosocial Support in PMTCT Programs Define the terms retention, adherence, and psychosocial support Understand the importance of retention,
More informationTB Outbreak Experience in British Columbia. Shelley Dean TB Control BC Centre for Disease Control
TB Outbreak Experience in British Columbia Shelley Dean TB Control BC Centre for Disease Control CVI TB Outbreak Introduction Early Cases Challenges Contact Tracing TB Incidence in BC by Origin and Year
More informationAIRBORNE PATHOGENS. Airborne Pathogens: Microorganisms that may be present in the air and can cause diseases in exposed humans.
MARICOPA COUNTY SHERIFF S OFFICE POLICY AND PROCEDURES Subject Related Information CRITICAL POLICY PURPOSE AIRBORNE PATHOGENS Supersedes CP-7 (8-14-15) Policy Number CP-7 Effective Date 01-04-17 The Office
More informationWHO/HTM/TB/ Task analysis. The basis for development of training in management of tuberculosis
WHO/HTM/TB/2005.354 Task analysis The basis for development of training in management of tuberculosis This document has been prepared in conjunction with the WHO training courses titled Management of tuberculosis:
More informationTube Feeding Status Critical Element Pathway
Use this pathway for a resident who has a feeding tube. Review the Following in Advance to Guide Observations and Interviews: Most current comprehensive and most recent quarterly (if the comprehensive
More informationINFECTIOUS DISEASE CLERKSHIP
College of Osteopathic Medicine INFECTIOUS DISEASE CLERKSHIP Office of Clinical Affairs 515-271-1629 FAX 515-271-1727 Elective Rotation General Description This elective rotation is a four (4) week introductory,
More informationFEDERAL MINISTRY OF HEALTH DEPARTMENT OF PUBLIC HEALTH. National Tuberculosis and Leprosy Control Programme. A Tuberculosis Infection Control Strategy
FEDERAL MINISTRY OF HEALTH DEPARTMENT OF PUBLIC HEALTH National Tuberculosis and Leprosy Control Programme FAST A Tuberculosis Infection Control Strategy 1 Acknowledgements This FAST Guide is developed
More informationJulian Surey TB Nurse Specialist
The London Chest TB Team 3 TB nurse specialists, 3 TB nurses Outreach worker Admin support Advocates Bengali & Somali TB consultant Specialist Paediactric team at RLH Case finding DIRECT REFERRALS TO SERVICE
More informationStark State College Policies and Procedures Manual
Stark State College Policies and Procedures Manual Title: BLOODBORNE INFECTIOUS DISEASES Effective: January 16, 2014 Policy No.: 3357:15-14-16 Revision 1 Page 1 of 2 POLICY: Start State College promotes
More informationTo provide a comprehensive, integrated written policy to prevent or minimize employee exposures to tuberculosis (TB).
TUBERCULOSIS EXPOSURE CONTROL PLAN 1. REFERENCES (a) U.S. Department of Labor, OSHA ltr Enforcement Policies and Procedures for Occupational Exposure to Tuberculosis dtd 8 Oct 93 (b) OSHA 2.106, Enforcement
More informationDirect cause of 5,000 deaths per year
HOSPITAL ACQUIRED (NOSOCOMIAL) INFECTION Policies MRSA Policy Meningitis Policy Blood and body fluid Exposure Policy Disinfection Policy Glove Policy Tuberculosis Policy Isolation Policy DEFINITION: ANY
More informationOral Ibrutinib (single agent)
Patient identifier/label: Page 1 of 6 PATIENT AGREEMENT TO SYSTEMIC THERAPY: CONSENT FORM IBRUTINIB Patient s surname/family name Patient s first names Date of birth Hospital Name: NHS number (or other
More informationMEDICATION NONADHERENCE THE HIDDEN EPIDEMIC
MEDICATION NONADHERENCE THE HIDDEN EPIDEMIC Drugs don t work in patients who don t take them. C. Everett Coop, MD 13 th Surgeon General of the United States February 3, 2018 Community Care of Wake and
More informationAPPENDIX A: WRITTEN EVALUATION
Unit 1 1. Feeding Assistants cannot assist residents with a history of aspiration or difficulty swallowing. 2. Feeding Assistants can assist with other Activities of Daily Living (ADL) care such as bathing
More informationTuberculosis (TB) risk assessment worksheet
128 Tuberculosis (TB) Risk MMWR Assessment Worksheet December 30, 2005 Tuberculosis (TB) risk assessment worksheet This model worksheet should be considered for use in performing TB risk assessments for
More informationStrategies to Improve Medication Adherence It Can Be SIMPLE
Strategies to Improve Medication Adherence It Can Be SIMPLE Shane Greene, Pharm.D. Director of Pharmacy Services Care N Care Insurance Company, Inc. Objectives Pharmacists: Identify predictors of medication
More informationAurora Behavioral Health System
Aurora Behavioral Health System Outpatient Services Help is only a phone call away. Aurora East 6350 S. Maple Ave. Tempe, AZ 85283 (The hospital is located on the NW corner of Guadalupe and Maple, between
More informationEducation Specialist Credential Program Application Full or Part Time. Student Information. Program Information. Field Placement (EHD 178)
Item 1 Education Specialist Credential Program Application Full or Part Time Semester of Application Semester/Year Student Information Last Name First Name Former Name (If applicable) Student ID Undergraduate
More informationIHF Training Manual for TB and MDR-TB Control for Hospital/Clinic/Health Facility Managers Executive Summary 2
EXECUTIVE SUMMARY International Hospital Federation Immeuble JB SAY, 13, Chemin du Levant, 01210 Ferney Voltaire, France Tel: +33 (0) 450 42 60 00 / Fax: +33 (0) 450 42 60 01 Email: info@ihf-fih.org /
More informationManagement of Patients with Known or Suspected Tuberculosis: Infection Control Issues IC/198/10
BASINGSTOKE AND NORTH HAMPSHIRE NHS FOUNDATION TRUST Management of Patients with Known or Suspected Tuberculosis: Infection Control Issues IC/198/10 Supersedes: previous policy IC/198/07 Owner Name Dr
More information2. Unlicensed assistive personnel: any personnel to whom nursing tasks are delegated and who work in settings with structured nursing organizations.
XVIII. A. General Information: The judgments that you make in about coordinating and facilitating client care situations have to be based on knowledge. You MUST know your content, and then you can move
More informationHealth Professions Council of South Africa Medical and Dental Professions Board
Health Professions Council of South Africa Medical and Dental Professions Board Board Examination for Foreign Medical Practitioners wishing to practice in SA Scope and guidelines of the examinations 1
More informationMOLLOY COLLEGE THE BARBARA H. HAGAN SCHOOL OF NURSING. CHECKLIST Everything must be completed
: MOLLOY COLLEGE CHECKLIST Everything must be completed 1. PHYSICAL EXAMINATION, completed on a School of Nursing Physical Form. Must be signed, stamped and dated by a Health Care Provider and include:
More informationNTNC: TB Program Core Competencies for PH Nurses 2008 and Future Challenges
NTNC: TB Program Core Competencies for PH Nurses 2008 and Future Challenges Kathleen Hursen, RN, MS MPD Division of TB Prevention and Control TB Control Priorities by 2015 1. 93% complete treatment
More informationFlossmoor: (708) Harvey: (708) Tinley Park: (708) ICOR: (708) Crestwood: (708) Patient Signature:
Patient Information Guidelines Department of Outpatient Therapy Services Physical, Speech and Occupational Therapy The staff at Ingalls Outpatient Therapy Services Department is dedicated to providing
More informationLESSON THREE. Administering oral, topical and inhaled medications
LESSON THREE Administering oral, topical and inhaled medications Introduction The most common route of medication administration is oral, although perhaps an easier one to prepare it still warrants careful
More information902 KAR 20:205. Tuberculosis (TB) testing for health care workers.
0 KAR :. Tuberculosis (TB) testing for health care workers. The final version was copied on April, from the Kentucky Legislative Commission Website, http://www.lrc.ky.gov/kar/0/0/.htm. 0 0 0 KAR :. Tuberculosis
More informationUsing Clinical Criteria for Evaluating Short Stays and Beyond. Georgeann Edford, RN, MBA, CCS-P. The Clinical Face of Medical Necessity
Using Clinical Criteria for Evaluating Short Stays and Beyond Georgeann Edford, RN, MBA, CCS-P The Clinical Face of Medical Necessity 1 The Documentation Faces of Medical Necessity ç3 Setting the Stage
More informationSOCIAL AND BEHAVIORAL SCIENCES EXERCISE 1: Explaining Health Behavior with the Health Belief Model- Screening for Latent Tuberculosis Infection
SBS Exercise 1: Explaining Health Behavior with the Health Belief Model (HBM) Estimated time to complete this exercise: 35 minutes LEARNING OBJECTIVES At the completion of this exercise, participants should
More informationJOB DESCRIPTION. Out of Hours Emergency Care Practitioner (Non-prescriber ECP)
JOB DESCRIPTION JOB TITLE: RESPONSIBLE TO: LOCATION(S): JOB PROFILE: Out of Hours Emergency Care Practitioner (Non-prescriber ECP) Head of Nursing Based at BrisDoc Operational bases throughout Bristol,
More informationTackling the challenge of non-adherence
Tackling the challenge of non-adherence 2 How is adherence defined? WHO definition: the extent to which a person s behaviour taking medication, following a diet and/or executing lifestyle changes corresponds
More informationHealth Professions Council of South Africa Medical and Dental Professions Board
Health Professions Council of South Africa Medical and Dental Professions Board Board Examination for Foreign Medical Practitioners wishing to practice in SA Scope and guidelines of the examinations 1
More information