Transcript Slide 1
TB Nurse Care Revisited:
Heartland National TB Center
Regional Perspective
Debbie Onofre RN, BSN
Texas Center for Infectious Disease
• 75 bed hospital
• One of Only 6 facilities in
the country specifically
designed to provide care
and treatment for patients
with TB
• First free-standing
infectious disease
hospital built in the U.S.
in more than 50 years
• A Project of the University of Texas Health Center,
Tyler
in partnership with:
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Centers for Disease Control and Prevention
Texas Center for Infectious Disease
Texas Department of State Health Services
TB Controllers in the Heartland Region
Heartland Region
13 States
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Arizona
Illinois
Iowa
Kansas
Minnesota
Missouri
Nebraska
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New Mexico
North Dakota
Oklahoma
South Dakota
Texas
Wisconsin
City of Chicago
City of Houston
Heartland’s Mission is to…
…Build capacity with our partners. We will share expertise
in the treatment and prevention of tuberculosis by
developing and implementing:
•Cutting-edge trainings
•Delivering expert medical consultation
•Providing technical assistance
•Designing innovative educational and consultative
products.
Objective
Use Awareness of Core Nursing Values to identify
strategies to address and/or avoid specific case
problems and challenges in the care of patients with
tuberculosis
National League for Nursing
• Core Values
– Caring
– Integrity
– Diversity
– Excellence
Nurse Case Management
• Patient Centered
– Cultural traditions
– Personal
preferences/values
– Family situations
– Social circumstances
– Lifestyles
Can We Provide Holistic Care?
• Nurse Shortage
• Budget Cuts
Nursing Shortage
• Forced into furloughs
• Expected to do same job
with limited resources
• Nursing positions
vacated/dissolved
What Does This Mean?
• No nurse to manage
TB cases
• Fewer nurses
dedicated to TB
control
• Lack of
Expertise
How Does Lack of Expertise Impact NCM?
• Impact on Nurse Case
Management activities
– Delayed recognition of TB
cases
– Missed opportunities to
identify and treat patients &
contacts
– Less expertise to manage
complicated cases
Increase in Medical Consultation for 2011
• PTB (complicated by co-morbidities)
– Extrapulmonary
305
– MDR
205
– XDR
34
– Pediatric
238
– HIV
154
261
Negative Outcomes as a Result of Poor NCM
• No expertise to Identify
inadequate treatment
– Treatment Failures
– Delayed Conversions
– Acquired Drug Resistance
• MDR
• XDR
Building Expertise
• Educating TB Nurses
– Nurse Case Management
• Live/Stand up
• Online
• Nurse Mini-Fellowships
– Basic
– Advance
• Conference Calls
Strive for TB NCM Excellence
• Continually promote
awareness regarding
core nursing values and
ensure:
– Caring
– Integrity
– Diversity
– Excellence
• Remains the mainstay in
TB care
Thank You!