Rose Barrajas, RN September 12, TB Nurse Case Management September 12 14, 2017

Transcription

1 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 to make: No conflict of interests No relevant financial relationships with any commercial companies pertaining to this educational activity

2 Rose Barajas, RN, BSN has the following disclosures to make: No conflict of interests No relevant financial relationships with any commercial companies pertaining to this educational activity

3 Objectives Define the role of the TB Nurse Case Manager Define Goals of Case Management Describe the Elements of Case Management Process Key facts Tuberculosis (TB) is one of the top 10 causes of death worldwide in In 2015, 10.4 million people fell ill with TB and 1.8 million died from the disease. In 2015, an estimated 1 million children became ill with TB and 170, 000 children died of TB. TB is a leading killer of HIV-positive people: in 2015, 35% of HIV deaths were due to TB.

4 USA Facts Progress toward TB elimination has stopped Latest data show the number of reported TB cases in the United States has increased for the first time in 23 years.

5 Toward TB Elimination TB Cases in Texas by County Harris Dallas Bexar Tarrant Hidalgo Cameron El Paso Travis Webb Fort Bend Collin 27 25

6 The Reason Why We Are Here According to ATS/CDC/IDSA Strategy : Patient-Centered Care and Case Management should be used Utilize case management interventions during treatment of patients with Tuberculosis 2016 ATS/CDC/IDSA TB Treatment Guidelines August 2016 Case Management: Primary responsibility for the coordination of patient care to ensure that the patient s medical and psychosocial needs are met through appropriate utilization of resources Fundamentals of TB Case Management, Barbara Cole, RN, PHN, MSN Role of TB Nurse Case Manager Ensure the care provided is culturally sensitive and acceptable to the patient Set goals, monitor outcomes and appropriately document interventions Maintain contact, not only with the patient, but with the care provider and others providing health related services to the patient

7 Goals of TB Case Management Render patient non-infectious by ensuring an adequate course of treatment, in accordance w/ TB Guidelines (CDC & DSHS) Prevent progression of TB and drug resistance by identifying & removing barriers to adherence Prevent TB transmission & development of disease with effective Contact Investigation (CI) Educate patient, family and community about TB Identify & address other urgent health needs How?

8 TB Nurse Case Management Process Case Finding Assessment Identify Problems Plan Implementation Evaluation Case Study 2 y/o Hispanic female admitted to hospital w/ pain & inability to move arm While hospitalized patient diagnosed w/ confirmed MTB Report received of need for patient to be followed per TB clinic Contact the medical care provider Health Program Specialist (HPS) is notified of patient & hospital/home visit is made Patient D/C from hospital with a appointment to TB clinic

9 Including: Clinical (H & P, D/C summaries, referrals) Gather & analyze Relevant data Psychosocial and behavioral health Chest X-ray Labs, Microbiology results Nutritional status Past medical history and current condition Concomitant diseases, Infectiousness etc. Case Finding Assessment Identify Problems Plan Implementation Including: Asses existing and/or potential health problems Coordinate team meetings to discuss patient s assessment Monitor outcomes and identify new problems Including: DOT administration (Adherence to treatment) Initiation of Treatment Monitoring (Clinical assessment for toxicity) Referrals Patient education Evaluation Documentation