Alaska Tuberculosis Program Manual - Epidemiology - State of Alaska

Case Management
CONTENTS
Introduction ........................................... 10.2
Purpose.............................................................. 10.2
Policy ................................................................. 10.3
Forms ................................................................. 10.4
TB Case Management Timeline ........................ 10.5
Initial Assessment ................................ 10.6
Cultural sensitivity and language issues ............ 10.6
Patient’s medical records ................................... 10.7
Assessment site ................................................. 10.7
Hospital Discharge planning .............................. 10.8
Initial assessment activities ................................ 10.8
Treatment Plan .................................... 10.14
Treatment plan components ............................ 10.15
Planning activities ............................................ 10.15
Implementation activities .................................. 10.17
Ordering TB medications ................................. 10.18
Ongoing Assessment
and Monitoring .................................... 10.20
Ongoing assessment activities ........................ 10.20
Monitoring side effects and
adverse reactions ............................................. 10.24
Activities to monitor for side effects and
adverse reactions ............................................. 10.24
Monitoring bacteriologic improvement ............. 10.25
Activities to monitor for bacteriologic and
clinical improvement ........................................ 10.25
Completion of Therapy ....................... 10.29
Verifying adequate course of treatment .......... 10.29
Calculating completion of therapy .................. 10.29
Documenting completion of treatment and
follow-up recommendations ............................ 10.30
Case closures other than completion
of therapy ........................................................ 10.31
Evaluation ............................................ 10.32
Evaluation activities ......................................... 10.32
Directly Observed Therapy ................ 10.34
Candidates for directly observed therapy ........ 10.34
How to deliver directly observed therapy ........ 10.35
DOT Aides, Regimens, and payment for DOT 10.35
Adherence to directly observed therapy .......... 10.38
Incentives and Enablers ..................... 10.40
Medical Orders .................................... 10.41
Progressive interventions ................................ 10.41
Resources and References ................ 10.42
A L A S K A T B P R O G R A M M A N U A L Case Management 10. 1
R e v i s e d N o v e m b e r 2 0 1 2