You are on page 1of 19

Tuberculosis &

Chest Service
CIHE-Year 3
Ching Tsz Shan 1670216
Deng Xue Tong 1670213
Brief Introduction of TB&CS
General services
1. Provides services for client with tuberculosis/ other chest diseases
2. Implements control and preventive measures against
tuberculosis/ other chest diseases

Specific Services
1. Directly-observed treatment
2. Health education of chest problems
Nurses Roles
1. Conduct chaperon duty in consultaion room
● prepare clinical doc. eg. X-rays films
2. Responsible for directly observed treatment duty in treatment room
● assess any complains
● prepare treatment cards
3. Perform health education in public health unit
● sputum collection, healthy lifestyle, home setting and hygiene
4. Trace defaulters
● clinic follow-up → X → phone calling etc.
Observation Area Flow
Where we were learn and observed
SOUTH KWAI CHUNG CHEST CLINIC
Consultation Room
Chaperon Duty

1. Preparing clinical documents


2. Assisting physical examination
3. Tracing patient information or relevant ducuments
4. Care coordination
5. Instruction for patients to different clinic points for
clinical services
Treatment Room
1. Infection control pratices
2. Directly Observed Treatment (DOT)
a. Drug storsge & custody
b. Guidelines or Service Protocols
c. Administration of DOT
d. Documentation
3. Specific nursing procedures
a. TB testing
b. BCG vaccination
c. vital signs and other assessment / investigations
Public Health Unit
❏ Patient interviews / Health counselling
❏ New TB cases
❏ Follow-up cases
❏ Health education
❏ sputum collection
❏ healthy lifestyle
❏ smoking cessation
❏ use of nasal spray and inhaler technique
❏ Management of TB
❏ Management of Latent TB Infection
❏ Defaclter tracing
❏ TB control Programme
Public Health Unit
❏ Defaclter tracing
❏ Defaulters of treatment
❏ Clinic follow-up
❏ Contact screening
❏ sputum collection
❏ TB control Programme
❏ Care coordination and collaboration
❏ Nursing Document
❏ Special duties of public health nurses
Special Health
Education
Sputum Collection Procedure & Tips
Quality sputum is crucial for sputum examination. If the specimen is
not collected by deep coughing, or it is contaminated by food particles,
it may lead to a false negative or false positive result.

What was observed?

1. Times for collection


2. Location for collection
3. Storage method of sputum
Directly Observed Treatment (DOT)
What is DOT?

1. DOT refers to the practice of observing the tuberculosis (TB) patient swallow
every dose of TB drugs by trained personnel.

2. DOT has been strongly recommended by the World Health Organization


(WHO) and the International Union Against Tuberculosis And Lung Diseases
(IUATLD) as one of the most reliable and well-established TB control
measures.
Components of DOT and significance in control TB in
comunity
1. Diagnosis by quality ensured sputum-smear microscopy.

2. Diagnosis by quality ensured sputum-smear microscopy

3. Standardized short-course anti-TB treatment (SCC) given under direct and


supportive observation (DOT).

4. regular, uninterrupted supply of high quality anti-TB drugs.

5. Standardized recording and reporting.

Sucessful control of TB is to stop it at the source


Advantages of DOT:
1. By enhancing treatment adherence,
DOT helps promote treatment
completion and reduce the risk of
acquiring drug resistance.

2. Treatment side effects may also be


more readily identified, and promptly
managed.
What happens during DOT?
1. Carried out by 2 nurses in the treatment room.

2. The patient is required to produce a personal treatment card.

3. Nurses will check the patient’s name on the treatment card.

4. Nurses dispense TB drugs according to the treatment card, double-check


the patient’s name before seeing the patient swallow the drugs,

5. ask how the patient feel after taking medicine, and record the patient’s
attendance.
Impressive Case observed
Defaulter Tracing…
● DOT on time on first few day, then absenced.
● Attended again but complained for ankle pain, nausea etc.
● Stop treatment, reserved for doctor consultation but absenced.

Phone calling but could not contact

Tracing for a period of time...


Client was admited to hospital.

● Keep contact with hospital and continue treatment at hospital


Special Learning Points
● Infection control
○ Actions to work out after receiving notification
○ To prioritise the people who exposed to TB
○ Arrange for contacts screening
● Advice / precautions to reduce the risk of transmission of TB
○ Personal hygiene
○ Home environment
○ Public health
THANK YOU

You might also like