Public Health Nurse I

Job Description :

Under the direction of the Communicable Disease Program Manager and the team leadership of the TB Nurse Consultant (Eastern), under moderate supervision with limited latitude for the use of initiative and independent judgment, performs comprehensive TB nursing services in Public Health Region 8 (PHR 8).

In collaboration with the TB Nurse Consultant, develop treatment plans for TB cases, suspects, and individuals with TB infection.

Perform nursing assessments to determine if a patient has TB. Provide case management of TB cases and suspects. Provide directly observed therapy (DOT) and directly observed preventive therapy (DOPT) to cases, suspects, and TBI cases.

Help ensure timely contact investigation completion for each case and suspect. Participate in program reviews of local health departments, contractors, and Department of State Health Services field offices to ensure all TB patients, suspects, contacts, and positive reactors receive quality TB nursing care and case management.

Present cases under management to the PHR 8 case review team. Provide technical assistance to private physicians, local health departments, regional field staff, correctional facilities, and the general public regarding TB.

Work is performed within the guidelines of the TB standing delegation orders (SDOs) with demonstrated nursing competencies in the assessment, evaluation, and management of TB suspects, cases, and contacts.

Conduct public awareness activities, training, and continuing education. Assist with other communicable disease activities in PHR 8.

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 :

25% TB Nursing Services and Case Management :

Provide specialized nursing services for patients diagnosed with TB or those suspected of having TB. Ensure TB patients, suspects, contacts, and positive reactors are appropriately managed and educated on tuberculosis transmission, infection, disease, and treatment within three days of initial report.

This includes : drawing labs; providing directly observed therapy (DOT); collecting sputum specimens; performing monthly toxicity screenings, documenting appropriately in patient’s charts, carrying out data entry, following through on lead TB Nurse Consultant and Medical Director instruction, educating clients and family and performing other patient management tasks as needed.

Provides assistance to TB program staff in managing patients diagnosed with TB, suspected TB, LTBI, or contacts / patients referred through EDN system.

Call and visit patients to help determine compliance with treatment. Collect lab specimens for analysis. Recognize the side-effects and interactions of TB drugs and request medical consultation to deal with such as needed.

Prepare and maintain patient charts according to established standards. Ensures all medical case management forms are complete and appropriately placed in medical charts.

Present patients under case management for the PHR 8 case review process. Provide education to patients and contacts of patients with TB on the transmission of TB, exposure risk, rationale for testing, meaning of test results, and, if positive for TB infection, actively encourages treatment regimens.

Consult with local health departments and other clinical contractors regarding TB services and case management. Stays up to date on required tuberculosis related continuing education, program and other region required trainings.

Stays up to date on required training. Abides by standing delegation orders and program policies and procedures. Must be able to independently drive and travel throughout the State of Texas and out-of-state to complete essential job functions.

20% Quality Assurance

Ensures compliance with DSHS TB Work Plan and maintains / updates clinical sections of the program manuals. Attends program meetings and meets with program staff to understand current processes and updates the regional TB Program Manual as outlined in the Texas TB Work Plan.

Develops, writes procedures and implements processes and tracking mechanisms to ensure adherence to clinical state and program standards.

Collaborates with clinical and surveillance staff to complete QA reviews of patient records and program processes throughout PHR 8, assuring adherence to SDOs, timeframes, and treatment protocols to determine compliance with nursing care policies and procedures.

Assists in compiling documents required to perform chart audits. Evaluate medical chart data for compliance requirements.

Analyze data from QA findings, provide written report of findings, and make recommendations for correction of deficiencies.

Monitor QA and case management activities of other TB team members. Participate in QA reviews conducted by the Central Office and, as requested, participate in QA reviews of local health departments or other regions.

Provides weekly updates on progress, projects, and assignments to the supervisor. Responds to requests from the Communicable Disease Manager for data and reports.

Must be able to independently drive and travel throughout the State of Texas and out-of-state to complete essential job functions.

20% 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 day cares, 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, spread of TB disease, and rationale for testing and treating LTBI.

Develops and provides training to contractors who provide DOT. Develops and provides training to program staff who provide patient management.

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.

10% Directly Observed Treatment (DOT) :

Provides DOT to TB cases / suspects and DOPT to TB contacts or LTBI clients as ordered by Medical Director. Reviews adverse reactions with client or parent at every visit.

Documents each visit on the DOT check list. Meets patient at assigned time and place and documents and notifies TB program staff if 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 check and documents on appropriate forms. Track DOT mileage. Abides by standing delegation orders and program policies and procedures.

Must be able to independently drive and travel throughout the State of Texas and out-of-state to complete essential job functions.

10% Contact Investigation :

With advanced interviewing techniques, elicits, and verifies contact information within seven days of suspect / case identification.

Using the concentric circle approach, conducts investigation to locate all appropriate contacts. Educate contacts on TB infection, disease, and treatment.

Evaluates 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 patient 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 in order to obtain orders for treatment of contacts to index case.

Abides by standing delegation orders and program policies and procedures. Must be able to independently drive and travel throughout the State of Texas and out-of-state to complete essential job functions.

10% Data Entry :

Carries out data entry of clinical data collected from patient encounters, lab results and chest x-ray results by TB staff.

Develops recommendations for incorporating data entry by clinical staff and provides written report of recommendations.

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 nursing and public health principles / practice including epidemiology, surveillance, disease prevention, health promotion, health and community assessment, and community collaboration
• Knowledge of local, state, and federal laws and ordinances pertaining to tuberculosis and other public health concerns
• Knowledge of CDC's TB treatment protocols and guidelines including DOT, targeted screening for TBI, and contact investigation
• Knowledge of the natural history and epidemiology of TB
• Knowledge of interviewing techniques, confidentiality, and the Health Insurance Portability and Accountability Act (HIPAA)
• Knowledge of infection control practices and procedures
• Knowledge of medical terminology and medical records
• Knowledge of and ability to use computerized telecommunications systems and data management and word processing software
• Knowledge of QA principles, evaluation methods, and data analysis
• Skill in communicating effectively, both orally (including public speaking) and in writing
• Skill in administering medication and vaccines and performing phlebotomy
• Skill in conducting patient assessments, TB skin tests, screening procedures, case management, and investigational interviews with patients, contacts, and healthcare providers
• Skill in developing and conducting individual and group training and continuing education workshops
• Ability to plan, coordinate, and evaluate delivery of direct and essential public health services to individuals, families, and communities
• Ability to conduct objective, comprehensive assessment plans
• Ability to prepare reports and develop training
• Ability to maintain interdisciplinary collaboration working relationships with the public and medical communities using tact and diplomacy
• Ability to work well and effectively in a team environment
20 days ago