Farley J.E., Kelly A.M., Reiser K., Brown M., Kub J., Davis J.G., Walshe L., Van Der Walt M.
School of Nursing, Johns Hopkins University, Baltimore, MD, United States; College of Nursing, Michigan State University, East Lansing, MI, United States; Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, United States; Tuberculosis Epidemiology and Intervention Research Unit, Medical Research Council, Pretoria, South Africa
Farley, J.E., School of Nursing, Johns Hopkins University, Baltimore, MD, United States; Kelly, A.M., College of Nursing, Michigan State University, East Lansing, MI, United States; Reiser, K., School of Nursing, Johns Hopkins University, Baltimore, MD, United States; Brown, M., School of Nursing, Johns Hopkins University, Baltimore, MD, United States; Kub, J., School of Nursing, Johns Hopkins University, Baltimore, MD, United States, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, United States; Davis, J.G., School of Nursing, Johns Hopkins University, Baltimore, MD, United States; Walshe, L., Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, United States; Van Der Walt, M., Tuberculosis Epidemiology and Intervention Research Unit, Medical Research Council, Pretoria, South Africa
Setting: Multidrug-resistant tuberculosis (MDR-TB) unit in KwaZulu-Natal, South Africa. Objective:To develop and evaluate a nurse case management model and intervention using the tenets of the Chronic Care Model to manage treatment for MDR-TB patients with a high prevalence of human immunodeficiency virus (HIV) co-infection. Copyright:Design: A quasi-experimental pilot programme utilizing a nurse case manager to manage care for 40 hospitalized MDR-TB patients, 70% HIV co-infected, during the intensive phase of MDR-TB treatment. Patients were followed for six months to compare proximal outcomes identified in the model between the pre-and post-intervention period.Results:The greatest percent differences between baseline and six-month MDR-TB proximal outcomes were seen in the following three areas: baseline symptom evaluation on treatment initiation (95% improvement), baseline and monthly laboratory evaluations completed per guidelines (75% improvement), and adverse drug reactions acted upon by medical and/or nursing intervention (75% improvement).Conclusion: Improvements were identified in guideline-based treatment and monitoring of adverse drug reactions following implementation of the nurse case management intervention. Further study is required to determine if the intervention introduced in this model will ultimately result in improvements in final MDR-TB treatment outcomes. © 2014 Farley et al.
cotrimoxazole; adolescent; adult; adverse outcome; aged; Article; case management; case manager; clinical article; controlled study; female; human; Human immunodeficiency virus infection; infection prevention; intensive care; male; medication compliance; mixed infection; multidrug resistant tuberculosis; nursing intervention; outcome assessment; practice guideline; prevalence; quasi experimental study; South Africa; case management; evaluation study; HIV Infections; model; nurse; organization and management; pilot study; standards; Tuberculosis, Multidrug-Resistant; Case Management; HIV Infections; Humans; Models, Nursing; Nurses; Pilot Projects; South Africa; Tuberculosis, Multidrug-Resistant