Partnering With Community Agencies To Conduct A Secondary


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Partnering With Community Agencies To Conduct A Secondary

  1. 1. Partnering with Community Agencies to Conduct a Secondary Prevention Program Margaret Hopkins, MS, RN Lois Schoener, PhD, RN, CNE
  2. 2. Partners <ul><li>Elmira College – </li></ul><ul><ul><li>Small liberal arts college in the Finger Lakes Region of upstate New York </li></ul></ul><ul><li>Schuyler County Health Agency – </li></ul><ul><ul><li>A county public health and certified home health agency </li></ul></ul><ul><li>The Falls Home </li></ul><ul><ul><li>100 bed residential care facility provides 2 levels of care: moderate and episodic nursing care </li></ul></ul>
  3. 3. TB Screening Clinic – Needs Assessment <ul><li>Epidemiology </li></ul><ul><ul><li>Caucasian elderly are among the fastest growing segments of the population with active TB </li></ul></ul><ul><ul><li>Those 65 years of age and older have the highest TB case rate per 100,000 population </li></ul></ul><ul><ul><li>Elderly housed in congregate living setting are at greater risk of contracting TB </li></ul></ul><ul><ul><li>Those with multiple high chronic diseases are at greater risk for TB </li></ul></ul>
  4. 4. TB Screening Clinic – Needs Assessment <ul><li>The Falls Home has 100 residents </li></ul><ul><li>Characteristics of Residents </li></ul><ul><ul><li>Age range 59-83 with majority over age 70 </li></ul></ul><ul><ul><li>98% of residents are Caucasian </li></ul></ul><ul><ul><li>Only 1 resident had known TB status </li></ul></ul><ul><ul><li>Medically fragile population with multiple chronic conditions </li></ul></ul>
  5. 5. Partner’s Goals <ul><li>PHA </li></ul><ul><ul><li>Improve the health of a community through case finding </li></ul></ul><ul><li>Adult Care Facility </li></ul><ul><ul><li>Maintain health of residents </li></ul></ul><ul><li>College </li></ul><ul><ul><li>Provide students with the opportunity to connect public health theory with practice </li></ul></ul>
  6. 6. Student Objectives <ul><li>Effectively apply knowledge about TB gained in the classroom and laboratory to clinical practice </li></ul><ul><li>Become competent in administering intradermal injections and assessing and classifying TB skin reactions </li></ul><ul><li>Use public health competencies in a case-finding experience for a high-risk population </li></ul><ul><li>Collaborate and cooperate with community agencies to implement a TB screening clinic </li></ul>
  7. 7. Organization of clinic <ul><li>Date for TB clinic mutually established </li></ul><ul><li>Each organization identified its contribution to the clinic </li></ul>
  8. 8. Student Preparation for Clinic <ul><li>Residents and their primary care physicians notified of the clinic </li></ul><ul><li>Immunization records updated </li></ul>
  9. 9. Implementation <ul><li>Organized and scheduled to allow appropriate timing for use of the two-step testing method and interpreting results </li></ul><ul><ul><li>First PPD administered </li></ul></ul><ul><ul><ul><li>Read 48 hours later </li></ul></ul></ul><ul><ul><li>Second test – 14 days after first test </li></ul></ul><ul><ul><ul><li>Read 48 hours later </li></ul></ul></ul>
  10. 10. Human resource contribution <ul><li>Elmira College </li></ul><ul><ul><li>12 Senior Nursing students in a community health course </li></ul></ul><ul><ul><li>Clinical faculty member </li></ul></ul><ul><li>Schuyler County Public Health Agency </li></ul><ul><ul><li>Resource nurse </li></ul></ul><ul><ul><li>MD for coverage </li></ul></ul><ul><li>The Falls Home </li></ul><ul><ul><li>Secretarial Staff </li></ul></ul><ul><ul><li>Aides </li></ul></ul>
  11. 11. Additional resource contribution <ul><li>Elmira College </li></ul><ul><ul><li>plan and implement clinic </li></ul></ul><ul><li>Schuyler County Public Health Agency </li></ul><ul><ul><li>Professional staff support – MD to “cover” clinic & PHN to verify questionable test results </li></ul></ul><ul><ul><li>Supplies – syringes, PPD Tuberculin, records </li></ul></ul><ul><li>The Falls Home </li></ul><ul><ul><li>Clinic space and staff to assist residents to clinic </li></ul></ul><ul><ul><li>Secretarial support </li></ul></ul><ul><ul><li>Stationery and postage </li></ul></ul>
  12. 12. Outcomes <ul><li>Clinic findings </li></ul><ul><ul><li>Total of 80 residents were screened </li></ul></ul><ul><ul><li>No significant PPD reactions were noted. </li></ul></ul><ul><li>The Falls Home </li></ul><ul><ul><li>The goal of maintaining the health of the residents was supported </li></ul></ul><ul><li>Schuyler County Public Health Agency </li></ul><ul><ul><li>The goal of improving the health of the community through secondary prevention measures was promoted. </li></ul></ul>
  13. 13. Outcomes <ul><li>Elmira College </li></ul><ul><ul><li>Goal to provide students with the opportunity to connect public health theory with practice was met </li></ul></ul><ul><li>Student Objectives </li></ul><ul><ul><li>All objectives were met </li></ul></ul><ul><ul><ul><li>Students effectively carried out the clinic and provided health education about TB </li></ul></ul></ul><ul><ul><ul><li>Each student administered 12 to 15 mantoux tests and read results of tests. </li></ul></ul></ul><ul><ul><ul><li>Students effectively collaborated with two organizations </li></ul></ul></ul>
  14. 14. Student Objectives <ul><li>Categories of public health competencies used by students in the implementation of the clinic: </li></ul><ul><ul><li>Basic Public Health Science Skills </li></ul></ul><ul><ul><li>Cultural Competency Skills </li></ul></ul><ul><ul><li>Communication Skills </li></ul></ul><ul><ul><li>Community dimension of practice skills </li></ul></ul><ul><ul><li>Program Planning </li></ul></ul><ul><ul><ul><ul><li>* Counicl on Linkages Between Academia and Public Helath Practice: Core Competencies for Public Health Professionals </li></ul></ul></ul></ul>
  15. 15. Epilogue <ul><li>Students and faculty provided more than 220 hours of service to the agencies </li></ul><ul><li>The responsibility for conducting this clinic was shared </li></ul><ul><li>The clinic was conducted at no cost to residents, allowing those with limited financial resources or health insurance to avail themselves of the service </li></ul><ul><li>All constituents expressed a high level of satisfaction with this project. As a result a tetanus immunization clinic was implemented for residents. </li></ul>