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TB Control Strategies in Michigan. Peter Davidson, Ph.D. TB Program Coordinator Michigan Dept. Comm. Health. Overview. Michigan TB overview Specific difficulties in MI Training courses TB nurse network Strategies / ideas for future. Michigan TB Overview.
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TB Control Strategies in Michigan Peter Davidson, Ph.D. TB Program Coordinator Michigan Dept. Comm. Health
Overview • Michigan TB overview • Specific difficulties in MI • Training courses • TB nurse network • Strategies / ideas for future
Reported TB Cases and Rates Michigan, 2001 - 2006 * Cases per 100,000. MI population 9.9 million as of 2000 census
Specific Difficulties in Michigan • LHDs often short-handed • Staff spread too thin to focus on TB • Staff turn-over prevents solid knowledge base • Maintaining focus on TB • We still have TB??? • Very few LHDs have staff or funding dedicated to TB prevention, education or control • TB responsibilities often integrated with CD, Imm, WIC or other programs. • LHD staff lack resources, time and support to educate or update themselves about TB • LHDs operate autonomously, no standardized forms or procedures between LHDs.
Specific Difficulties in Michigan:Summary A case may easily become a crisis.
Michigan TB Trainings: Overview • Initiated in 2002 • Goal: Maintain expertise by providing educational opportunities to LHDs on core principles and practices of TB control • Four training modules available • TST (Train-the-trainer also available) • Case Management • Contact Investigation • DOT • Fit testing for N-95 masks
Michigan TB Nurse Network:Why Focus on Nurses? Nurses are the basis for quality patient care. • > 85% of all public and private healthcare is directly administered through nurses • Nurses are trained to manage a patient’s care during major and subtle health issues • Assess, monitor & diagnose pt’s status • Recommend & deliver meds • Provide & document case management • Integral to quality patient care
Michigan TB Nurse Network: Purposes • Provide updates and education regarding state and national TB guidelines • Provide a forum for discussion of TB case management • Link novice TB nurses with experienced and knowledgeable TB nurses: friendly developmental networking • Increase MDCH TB Control staff awareness of educational needs, barriers and challenges faced by LHD staff • Improve partnership and collaboration between LHDs, MDCH, non-profit and private health care entities • Increase understanding and use of MDCH TB laboratory by LHDs.
Michigan TB Nurse Network:Brief History • Originally 12 counties in SE Michigan • First meeting 3/05, 5 nurses and 1 supervisor • Currently 14 counties from central and lower Michigan, 28 members • Nurse Network meetings held quarterly in Lansing (centrally located).
Michigan TB Nurse Network: Products • Quarterly interdisciplinary discussion of TB case management • Inclusion of TB training in the curricula of academic partners educating health care professionals • Mott Community College • Glen Oaks Community College • Oakland University • Michigan State University • University of Michigan • Linkages w/ advocacy partners also at MDCH • MDCH Immunizations: collaboration for exhibitions; immunization toolkit featuring TB materials • MDCH Office of Drug Control Policy: Staff at substance abuse centers have rec’d training to interpret TST
Michigan TB Nurse Network:In Process • TB Toolkit as resource for health care workers • Concise, step-by-step guide for TB case management from initial determination of case to completion of therapy • Program evaluation of TST course • On site observation of TST courses to evaluate the course as it is presented and the instructor. Overall feedback from the instructors has been very positive
Acknowledgements Gail Denkins, RN, BS Nurse Educator Julie McCallum, RN, MPH Nurse Educator Andrew Knecht, MPH TB Epidemiologist Tracina Cropper, BS CDC PHA
