Nursing implementation
- Health Promotion
- Ultimate goal in the United States is eradication
- Selective screening programs in high-risk groups to detect TB
- Treatment of LTBI
- Follow-up positive TST results
- Reportable disease
- Address social determinants of TB
- Acute Care
- Airborne isolation
- Single-occupancy room with 6-12 airflow exchanges/hour
- Health care workers wear high-efficiency particulate air (HEPA) masks
- Immediate medical workup
- Appropriate drug therapy
- Teach patient to prevent spread
- Cover nose and mouth with tissue when coughing, sneezing, or producing sputum
- Hand washing after handling sputum-soiled tissues
- Patient wears mask if outside of negative-pressure room
- Identify and screen close contacts
- Airborne isolation
- Ambulatory Care
- Can go home even if cultures positive
- Monthly sputum cultures
- Teach patient how to minimize exposure to others
- Ensure that patient can adhere to treatment
- Negative cultures are needed to declare the patient not infectious
- Notify health department
- Teach symptoms of recurrence
- Instruct about factors that could reactivate TB
- Smoking cessation
Evaluation
- Expected Outcomes
- Resolution of disease
- Normal pulmonary function
- Absence of any complications
- No further transmission of TB
Patient teaching
- Emphasize the importance of complying with his medication regimen.
- Teach him how to minimize exposure to close contacts.
- They should open windows and ventilate rooms in which he is living.
- Until their sputum is negative for AFB,
- Should sleep alone
- Spend as much time as possible outdoors, and minimize time in close proximity with other people and on public transportation.
- Emphasize importance of treatment compliance.
- Strategies to improve adherence to drug therapy include
- Teaching and counseling
- Reminder systems
- Incentives or rewards
- Contracts and DOT
