Download Preventive TB Procedure

Preventive TB Procedure
PURPOSE:
To treat patients with inactive tuberculosis infection in order to prevent the
progression to active disease
EQUIPMENT:
Chart, Family Data Sheet, Pre-TB Clinic Initial Patient Questionnaire, TB
Program Monthly Flow Sheet, Periodic Patient Questionnaire, Pamphlets,
Care Plan.
PROCEDURE:
1.
Preventive treatment for inactive tuberculosis infection is done either in
accordance with therapy begun elsewhere, or in accordance with a
decision made by the Medical Director or his designate at the Doctor’s
Tuberculosis Clinic. See the procedure descriptions for the
appropriate situation.
2.
The public health nurses are empowered to discuss with clients the
relative risks and benefits of choosing to take treatment to prevent
tuberculosis. Clients who feel they understand the risks and benefits
may reach their decision in conjunction with the public health nurse
about whether to take preventive treatment for tuberculosis. They will
need to sign the informed consent, just as they would have in Doctor’s
Tuberculosis Clinic. In these cases, the appropriate paperwork,
including the Pre-TB Clinic Initial Patient Questionnaire and any
accompanying X-ray and laboratory results, will be presented to the
Medical Director or his designate for a consultation regarding
preventive treatment for tuberculosis. However, in this case the client
does not need to be present in person for the consultation. If the client
does not feel like he understands the issues adequately to make a
decision, if he/she would prefer to speak to a doctor before making the
decision, or if there are any issues which the public health nurse feels
are beyond his/her ability to address adequately, then the client will be
seen in person at the Doctor’s Tuberculosis Clinic.
2.
In either situation, the patient should have a chart made up and
completion of the Family Data Sheet, Pre-TB Clinic Initial Patient
Questionnaire, TB Program Monthly Flow Sheet, and during the
monthly medication visits, completion of the Periodic Patient
Questionnaire.
3.
Details of exact medications are in accordance with those ordered by
the physician. The nurse distributes the medications monthly in
accordance with the procedure described for monthly medication pickup. When the patient has questions which are difficult for the nurse to
answer, or signs or symptoms suggestive of medication toxicity,
treatment failure, or another illness which requires physician attention,
the nurse will contact the physician for further instructions.
4.
Generally the indications for treatment and the details of the treatment
regimen are consistent with those discussed in reference (1) or more
current standards. When this is not so, the Medical Director or his
designate will confer with an appropriate specialist or resource to
assure the treatment given is appropriate.
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REFERENCE
(1)
American Thoracic Society (and Centers for Disease Control and Prevention),
Treatment of Tuberculosis and Tuberculosis Infection in Adults and Children, Am J
Respir Crit Care Med, Volume 149, pp 1359-1374, 1994.
Rev. 10/8/1999
TB/Manual/PreventiveTBProcedure.doc
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