141st APHA Annual Meeting

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Responding to a community tuberculosis outbreak: Public health nursing interventions

Monday, November 4, 2013

Deborah Swanson, RN, BSN , College of Nursing and Professional Disciplines, University of North Dakota, Grand Forks, ND
The role of the public health nurse in responding to a TB outbreak is instrumental in controlling the disease and preventing further spread in a community. This presentation focuses on the interventions carried out by public health nurses in Grand Forks, ND where a TB outbreak occurred in late 2012 and early 2013. The population affected had unstable housing, low socioeconomic status and other risk factors for tuberculosis. There were a total of 20 adult and pediatric cases of TB identified among a closely connected social network with multiple and prolonged exposures to other residents of the community. Public health nurses were responsible for an array of activities from the Public Health Wheel of Intervention including: surveillance, health event investigation, outreach, screening, referral and follow up, case management, and delegated functions such as directly observed therapy for medication compliance. The public health nurses collaborated with health care providers and area schools to establish a TB task force. The task force served as a conduit of information to the public through the media. TB skin testing and health teaching were provided at three schools, multiple worksites, and at the local health department. As a result, 40 individuals were placed on preventive therapy for latent TB infection. Social determinants of health such as poverty, lack of housing, unemployment and incarceration were impediments to successful treatment; however, the public health nurses remained committed to the goal of 100% completion of treatment for all TB patients.

Learning Areas:
Protection of the public in relation to communicable diseases including prevention or control

Learning Objectives:
Identify public health nursing interventions necessary to control TB in a community. Describe how the social determinants of health impact the spread of TB in a vulnerable population.

Keywords: TB, Public Health Nursing

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am the Public Health Nursing Director at Grand Forks (ND) Public Health Dept., responsible for disease prevention, family health, health promotion and health services teams. I created the TB Task Force to provide leadership and coordinate activities related to a local TB outbreak in 2012 - 2013.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.