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Publ Hlth and Prevent Spcl I
3 months ago
Under the supervision of the Communicable Disease Program Manager and the team leadership of the TB Nurse Lead, performs routine level public health work in the assigned counties of PHR 8 and the binational TB program. In collaboration with the TB Nurse Lead, provides support with and/or develops treatment plans for persons with TB disease, suspects, and individuals with TB infection (TBI). Perform nursing assessments to determine if a patient has TB. Provides support with and/or provides case management of persons with TB and suspects. With guidance and support from the lead public health nurse, participates in coordinating treatment plans to include directly observed therapy (DOT). Provide directly observed therapy (DOT) and directly observed preventive therapy (DOPT) to persons with TB disease, suspects, and persons with TB infection. Conducts surveillance to identify persons with TBI or disease. Educates tuberculosis suspects, persons with TB disease, and contacts on TB transmission, pathogenesis, and treatment process. Using judgment and tact elicits contacts and expands the concentric circle when appropriate. Participates in case reviews to ensure treatment guidelines are met. Prepares monthly performance measures report. Performs other communicable disease-related activities as required. Works under moderate supervision, with limited latitude for the use of initiative and independent judgment. Works evenings, holidays, and weekends as requested. Must be able to independently drive and travel throughout the State of Texas and out-of-state to complete essential job functions. Essential Job Functions:
35% TB Case Management:
Educates tuberculosis suspects, contacts, and cases on tuberculosis transmission, infection, disease, and treatment within three days of the initial report. In coordination with the TB Nurse Lead, actively provides and/or supports case management of tuberculosis (TB) suspects, cases, and persons with TB infection (TBI) for the assigned counties of PHR 8, the binational program, congregate settings, and correctional facilities. Prepares patient summary reports and participates in case reviews to ensure treatment guidelines are met. Reviews TB reporting forms (TB s) for accuracy and completeness with timely submission. Ensures all medical case management forms are complete and appropriately placed in medical charts. Obtains sputum specimen for acid-fast bacteria (AFB) testing and packaged for mail to DSHS lab. Provide education to patients and contacts of patients on TB, the transmission of TB, exposure risk, the rationale for testing, meaning of test results, and, if positive for TBI, actively encourages treatment regimens. Assist lead TB nurse in managing the patient care of patients and/or manage the patient care of patients diagnosed with TB, suspected TB, TBI, patients who are contacts to cases or referred for an evaluation by other jurisdictions, and patients referred through the EDN system. This includes drawing labs; providing directly observed therapy (DOT); collecting sputum specimens; performing and/or supporting monthly toxicity screenings, documenting appropriately in patient’s charts, carrying out data entry, following through on lead TB nurse and medical director instruction, educating clients and family and performing other patient management tasks as needed. If a patient moves outside of the initial county of diagnosis will continue to follow up with other jurisdictions and facilities outside of the original county, to ensure proper patient management and treatment completion. Abides by standing delegation orders and program procedures. Carry out QA reviews of patient records throughout PHR 8, assuring adherence to SDOs, time frames, and treatment protocols to determine compliance with nursing care policies and procedures. Assists in compiling documents required to perform chart audits. Ensures medical supplies and needed medications are available and current. Assist/perform phone calls and follow-ups, sending faxes, communicating with other healthcare providers, scheduling of patients, and other clinic functions. Carries out quality assurance audits to contractors who provide DOT. Monitor QA and case management activities of other TB team members. Evaluate medical chart data for compliance requirements. Conduct QA review of DOT contractors and/or binational contractors. Participate in QA reviews conducted by the Central Office and, as requested, participate in QA reviews of local health departments or other regions. Completes reports as requested by the communicable disease manager and TB Nurse lead. Stays up to date on required tuberculosis-related continuing education, program, and other region-required training. Provides support in completing the TB program Annual Report and TB Program Manual. Provides support in meeting activities as outlined in the Texas TB Work Plan. Must be able to independently drive and travel throughout the State of Texas and out-of-state to complete essential job functions.
20% Directly Observed Therapy (DOT):
Provides in-person DOT and/or Video DOT to TB cases/suspects and DOPT to TB contacts or TBI clients as ordered by TB physician. Reviews adverse reactions with client or parent at every visit. Documents each visit on the DOT checklist. Meets patient at assigned time and place and documents and notifies TB nurses if the patient does not show or cannot attend DOT. Assures treatment compliance by providing DOT/DOPT services. Assesses patient environment to reduce risk of transmission and minimize delinquency. Performs DOT/DOPT toxicity checks and documents on appropriate forms. Track DOT mileage. Provide education to the patient on the use of VDOT, obtain VDOT consents, review patient’s medication recordings. Abides by standing delegation orders and program procedures. Must be able to independently drive and travel throughout the State of Texas and out-of-state to complete essential job functions.
15% Contact Investigation:
With advanced interviewing techniques, elicits, and verifies contact information within seven days of suspect/case identification. Using the concentric circle approach investigates to locate all appropriate contacts. Educate contacts on TB infection, disease, and treatment. Evaluate contacts for infection or disease based on window and post window tuberculin skin testing or blood tests. Assures appropriate follow-up to complete evaluation. Accurately completes contact evaluation and investigation forms with timely submission to the lead contact investigator. Reviews contact information forms for completeness. Using the concentric circle map assesses investigation results to determine contact expansion. Actively case manages contacts to a known source case. Interviews patients with confirmed TB or suspected to have TB within 7 days of notification to DSHS TB staff. Collaborates with contact investigation coordinator to: determine the scope of the contact investigation, provide a summary of contacts listed and whether the contacts are low, medium, or high priority, update current results from contacts tested, obtain CXR referrals for patients as needed and data enter patient information. Completes / reporting form and sends completed form to contact investigation coordinator for audit and reporting. Ensures all documentation is provided to contact investigation coordinator to obtain orders for treatment of contacts to the index case. Abides by standing delegation orders and program procedures. Must be able to independently drive and travel throughout the State of Texas and out-of-state to complete essential job functions.
15% Data Entry and Training:
Stays up to date on required State systems training. Carries out data entry of clinical information and surveillance data collected from patient encounters, lab results, and radiology results. Enters information for community, corrections, and binational patients.
10% Education and Training:
Provide technical assistance to private physicians, local health departments, regional staff, correctional facilities, and the general public. Develop and conduct in-service training and continuing education for healthcare providers, hospitals, correctional facilities, workplaces, and the public. Coordinates, educates, and counsels on the implementation of DOT and treatment of TB infection for the prevention of tuberculosis disease to include health care providers, school nurses, high-risk nursing homes, and other community providers as needed. Provides education to facilities undergoing large contact investigations. These include, but are not limited to nursing homes, adult daycares, correctional facilities, schools, and community medical providers. Develops educational material on TB for patients and families in English or Spanish. Provides education to patients and patient contacts about TB, LTBI, the spread of TB disease, and rationale for testing and treating LTBI. Develops and provides training to contractors who provide DOT. Acts as a liaison/resource to health delivery service centers in the community to assure appropriate management of suspects, cases, and persons with latent TB infection. Must be able to independently drive and travel throughout the State of Texas and out-of-state to complete essential job functions.
5% Other Duties:
Other duties as assigned include but are not limited to actively participating and/or serving in a supporting role to meet the agency’s obligations for disaster response and/or recovery or Continuity of Operations activation. Such participation may require an alternate shift pattern assignment and/or location. Safe operation of either a state-owned vehicle or personal vehicle is required to conduct state business and an acceptable driving record must be maintained in accordance with DSHS Policy 06-, Fleet Operations and Management & Procedures, and standards developed by the Texas Department of Public Safety. Complies with the Department of State Health Services Immunization Policy. Support other PHR 8 programs (Border Health, Epidemiology, HIV/STD, Immunizations, and Zoonosis Control) as needed, including providing immunizations, testing and treating STD patients, and assisting with disease outbreak investigations. Provide general nursing or other support services in the event of a natural or man-made disaster. Knowledge Skills Abilities:
Knowledge of public health law (tuberculosis), public health nursing, and public health principles/practice including epidemiology, disease prevention, health promotion, health and community assessment, and community collaboration.
Knowledge of CDC’s treatment protocols and guidelines including directly observed therapy, targeted screening for latent TB infection, and contact investigation.
Knowledge of case management techniques.
Knowledge of local, state, and federal laws and procedures about tuberculosis and disease surveillance.
Knowledge of community resources.
Knowledge of medical terminology.
Knowledge of teaching/learning theories and curriculum development principles.
Knowledge of principles of quality assurance, evaluation methods, and data analysis.
Skill in administering medication and vaccines and phlebotomy.
Skill in developing and conducting individual and group training, continuing education workshops.
Skill in conducting patient assessments, administering and reading TB skin tests, performing screening procedures, conducting case management and investigational interviews with patients, contacts, and health care providers.
Skill in case analysis for case management purposes.
Skill in interpreting and evaluating treatment, radiographic and bacteriological data.
Skill in developing guidelines/protocols.
Skill in the use of a personal computer
Ability to plan, coordinate and evaluate the delivery of direct public health services and essential public health services to individuals, families, and communities; conduct objective, comprehensive assessment plans.
Ability to interpret public health law.
Ability to function independently, plan, assign and/or supervise staff, delegate appropriately, and maintain confidentiality.