tb control strategies in michigan
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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. - PowerPoint PPT PresentationTRANSCRIPT
TB Control Strategies in Michigan
Peter Davidson, Ph.D.Peter Davidson, Ph.D.
TB Program CoordinatorTB Program Coordinator
Michigan Dept. Comm. HealthMichigan Dept. Comm. Health
OverviewOverview
Michigan TB overviewMichigan TB overview– Specific difficulties in MISpecific difficulties in MI
Training coursesTraining courses
TB nurse networkTB nurse network
Strategies / ideas for futureStrategies / ideas for future
Michigan TB OverviewMichigan TB Overview
Reported TB Cases and Rates Reported TB Cases and Rates Michigan, 2001 - 2006Michigan, 2001 - 2006
* Cases per 100,000. MI population 9.9 million as of 2000 census
YearYear CasesCases Rate*Rate*
20012001 329329 3.33.3
20022002 315315 3.13.1
20032003 243243 2.42.4
20042004 272272 2.72.7
20052005 246246 2.42.4
20062006 221221 2.22.2
TB Burden, Michigan Counties, 2006TB Burden, Michigan Counties, 2006
Population Density,Population Density,Michigan Counties, 2000Michigan Counties, 2000
Michigan Health DistrictsMichigan Health Districts
Specific Difficulties in MichiganSpecific Difficulties in Michigan
LHDs often short-handedLHDs often short-handed– Staff spread too thin to focus on TBStaff spread too thin to focus on TB– Staff turn-over prevents solid knowledge baseStaff turn-over prevents solid knowledge base
Maintaining focus on TBMaintaining focus on TB– We still have TB???We still have TB???– Very few LHDs have staff or funding dedicated to TB prevention, Very few LHDs have staff or funding dedicated to TB prevention,
education or controleducation or control– TB responsibilities often integrated with CD, Imm, WIC or other TB responsibilities often integrated with CD, Imm, WIC or other
programs.programs.
LHD staff lack resources, time and support to educate or LHD staff lack resources, time and support to educate or update themselves about TBupdate themselves about TB
LHDs operate autonomously, no standardized forms or LHDs operate autonomously, no standardized forms or procedures between LHDs.procedures between LHDs.
Specific Difficulties in Michigan:Specific Difficulties in Michigan:SummarySummary
A case may easily become a crisis.A case may easily become a crisis.
Michigan TB TrainingsMichigan TB Trainings
Michigan TB Trainings: OverviewMichigan TB Trainings: Overview
Initiated in 2002Initiated in 2002Goal: Maintain expertise by providing educational Goal: Maintain expertise by providing educational opportunities to LHDs on core principles and opportunities to LHDs on core principles and practices of TB controlpractices of TB controlFour training modules availableFour training modules available– TST (Train-the-trainer also available)TST (Train-the-trainer also available)– Case ManagementCase Management– Contact InvestigationContact Investigation– DOTDOT
Fit testing for N-95 masksFit testing for N-95 masks
Michigan TB Trainings: ImpactMichigan TB Trainings: Impact
CourseCourse Date Init.Date Init.Times Times
OfferedOfferedNumber of Number of ParticipantsParticipants
TSTTST 7/037/03 423423 4,8564,856
TST-TTTTST-TTT 7/037/03 148148 421421
CICI 8/028/02 1818 242242
CMCM 7/037/03 1111 153153
DOTDOT 10/0610/06 33 6464
N-95N-95
Fit TestFit Test2/022/02 3131 461461
Michigan TB Nurse NetworkMichigan TB Nurse Network
Michigan TB Nurse Network:Michigan TB Nurse Network:Why Focus on Nurses?Why Focus on Nurses?
Nurses are the basis for quality patient care.Nurses are the basis for quality patient care.
> 85% of all public and private healthcare is directly > 85% of all public and private healthcare is directly administered through nursesadministered through nursesNurses are trained to manage a patient’s care during Nurses are trained to manage a patient’s care during major and subtle health issuesmajor and subtle health issues– Assess, monitor & diagnose pt’s statusAssess, monitor & diagnose pt’s status– Recommend & deliver medsRecommend & deliver meds– Provide & document case managementProvide & document case management– Integral to quality patient careIntegral to quality patient care
Michigan TB Nurse Network: Michigan TB Nurse Network: PurposesPurposes
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:Michigan TB Nurse Network:Brief HistoryBrief History
Originally 12 counties in SE MichiganOriginally 12 counties in SE Michigan– First meeting 3/05, 5 nurses and 1 supervisorFirst meeting 3/05, 5 nurses and 1 supervisor
Currently 14 counties from central and lower Currently 14 counties from central and lower Michigan, 28 membersMichigan, 28 members
Nurse Network meetings held quarterly in Lansing Nurse Network meetings held quarterly in Lansing (centrally located).(centrally located).
Michigan Health DistrictsMichigan Health Districts
Michigan TB Nurse Network: Michigan TB Nurse Network: ProductsProducts
Quarterly interdisciplinary discussion of TB case managementQuarterly interdisciplinary discussion of TB case managementInclusion of TB training in the curricula of academic partners Inclusion of TB training in the curricula of academic partners educating health care professionalseducating health care professionals
– Mott Community CollegeMott Community College– Glen Oaks Community CollegeGlen Oaks Community College– Oakland UniversityOakland University– Michigan State UniversityMichigan State University– University of MichiganUniversity of Michigan
Linkages w/ advocacy partners also at MDCHLinkages w/ advocacy partners also at MDCH– MDCH Immunizations: collaboration for exhibitions; immunization MDCH Immunizations: collaboration for exhibitions; immunization
toolkit featuring TB materialstoolkit featuring TB materials– MDCH Office of Drug Control Policy: Staff at substance abuse centers MDCH Office of Drug Control Policy: Staff at substance abuse centers
have rec’d training to interpret TSThave rec’d training to interpret TST
Michigan TB Nurse Network:Michigan TB Nurse Network:In ProcessIn Process
TB Toolkit as resource for health care workersTB Toolkit as resource for health care workers– Concise, step-by-step guide for TB case management from Concise, step-by-step guide for TB case management from
initial determination of case to completion of therapyinitial determination of case to completion of therapy
Program evaluation of TST courseProgram evaluation of TST course– On site observation of TST courses to evaluate the course On site observation of TST courses to evaluate the course
as it is presented and the instructor. Overall feedback from as it is presented and the instructor. Overall feedback from the instructors has been very positivethe instructors has been very positive
AcknowledgementsAcknowledgements
Gail Denkins, RN, BSGail Denkins, RN, BS Nurse EducatorNurse Educator
Julie McCallum, RN, MPHJulie McCallum, RN, MPH Nurse EducatorNurse Educator
Andrew Knecht, MPHAndrew Knecht, MPH TB EpidemiologistTB Epidemiologist
Tracina Cropper, BSTracina Cropper, BS CDC PHACDC PHA
Thank you!Thank you!
Questions?Questions?
Getting Buy-In: Tips and HintsGetting Buy-In: Tips and Hints
Exhibit Exhibit oftenoften
Keep the Keep the web currentweb current
Cancel class for Cancel class for lack of interestlack of interest
CommunicateCommunicate
InviteInvite InviteInvite
InviteInvite And Invite And Invite again!again!
Offer Offer varietyvariety
Offer the Offer the easy buttoneasy button
Offer Offer optionsoptions
Offer foodOffer food