Alaska Tuberculosis Program Manual - Epidemiology - State of Alaska

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MEMORANDUM OF AGREEMENT between Directly Observed Therapy (DOT) Aide and the Alaska TB Program 1. The DOT Aide will perform all duties and responsibilities outlined in the DOT Aide Job Description. This includes ensuring safe and child proof storage of all medications, asking about side effects and stopping medications as instructed, notifying the PHN if the patient does experience side effects or misses doses, watching the patient swallow each dose of medications, maintaining the patient’s confidentiality, and recording all doses on the DOT Calendar. 2. The DOT Aide will complete and mail or FAX a Monthly Invoice for Payment and a Monthly DOT Calendar to the Public Health Nurse (PHN) after the last day of each month in which the Aide provides the patient with DOT services. 3. The DOT Aide will receive payment for their services once per month from the Alaska TB Program. This process takes up to 4 weeks from the time that the PHN sends the DOT Aide’s approved Monthly Invoice for Payment and Monthly DOT Calendar to the Alaska TB Program. 4. Direct Deposit of funds into the DOT Aide’s bank account is an option that makes payment faster. To request this, DOT Aides will need to complete and submit the Electronic Payment Agreement with the first invoice and calendar. Electronic payment requests take at least 1 billing cycle for processing. 5. The Alaska TB Program cannot guarantee the amount of work involved for each patient’s care. The amount of work will vary depending on the patient’s needs. 6. Job duties and responsibilities are described in the DOT Aide Job Description (see attached). AGREEMENT I, _________________________, _______________, agree to provide tuberculosis medicines to Name of DOT Aide Social Security # _______________________________, ____________________, of ______________________, Name of Patient HR # Name of Village Alaska for a period of time and according to directions specified by the patient’s health care provider and the PHN. I understand I will be paid $10.00 for each day I observe administration of TB medicines. Signature of DOT Aide: _____________________________________ Date: _____________ Signature of Supervising PHN: _______________________________ Date: _____________ Signature of Alaska TB Program: _____________________________ Date: _____________ Rev 11/12
Alaska TB Program Section of Epidemiology 3601 C Street, Suite 540 Anchorage, AK 99503 (907) 269-8000 (907) 563-7868 (fax) DOT AIDE MONTHLY INVOICE FOR PAYMENT Today’s date:___________________________________________ Invoice for the month of:__________________________________ Patient HR#____________________________________________ Number of daily DOT doses provided: x $10.00 Total payment requested: $______________ Send payment to: Name:________________________________________________ ________________________________________________ ________________________________________________ PVN:__________________________________ Signed:______________________________________________ DOT Aide Signed:______________________________________________ Supervising PHN Please fax this form and monthly calendar to: ___________________________________________, PHN at 907-_______-____________ Rev 11/12
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Alaska Tuberculosis Program Manual
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Purpose............................
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Monthly assessment of adherence ...
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When to Expand a Contact Investigat
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Introduction CONTENTS About the Ala
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How to Use This Manual Portable Doc
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Printing To access the print dialog
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Abbreviations Refer to the list bel
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QFT QuantiFERON ® -TB test QFT-G Q
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Alaska Statutes and Regulations on
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National and State Program Objectiv
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Indicator 3 Thorough contact invest
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National Standards and Recommendati
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Roles and Responsibilities Contact
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Local Public Health Agencies Table
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Resources and References Resources
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Introduction Purpose Use this secti
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Contact investigation: Collecting,
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Reporting Tuberculosis Detecting an
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Prompt reporting (prior to culture
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Use the Infectious Disease Report F
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Data Collection Forms The following
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Genotyping Genotyping is a useful t
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References 1 ATS, CDC, IDSA. Contro
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child or a person acting on behalf
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When to Conduct Targeted Testing Al
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Alaska Program Standards for Health
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B Notifications CONTENTS Introducti
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Table 1: NUMBERS OF FOREIGN-BORN PE
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chest radiograph and if sputum AFB
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Follow-up of B1 and B2 Tuberculosis
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Evaluation of B1, B2, and B Tubercu
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Treatment Prescribe medications as
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12 Centers for Disease Control and
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Tuberculosis Classification System
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Table 2: PERSONS AT HIGH RISK FOR T
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Table 3: WHEN TO SUSPECT PULMONARY
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Diagnosis of Tuberculosis Disease T
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1. Exposure to Infectious TB: Ask p
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Physical Examination A physical exa
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For more information on chest radio
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Laboratories should report positive
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Guidelines for preventing the trans
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50 CDC. National plan for reliable
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Introduction Purpose The overall go
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Basic Treatment Principles Follow t
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Treatment Regimens and Dosages Use
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Table 3: FOUR TREATMENT REGIMENS FO
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† 4 Table 4: DOSES*OF FIRST-LINE
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Figure 1:TREATMENT ALGORITHM FOR DR
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a. In remote locations in Alaska, m
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Antituberculosis Drug Rifampin (RIF
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Antituberculosis Drug Rifapentine (
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Reporting Reactions The table below
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Response to Treatment For consultat
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Figure 2: MANAGEMENT OF TREATMENT I
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Post-Treatment Evaluation Routine f
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Treatment in Special Situations Tre
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Resources For consultation regardin
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with an increase in overall complet
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Liver Disease Management of TB in p
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After the initial phase (first two
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Extrapulmonary Tuberculosis The bas
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Diagnosis of Latent Tuberculosis In
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Forms All required and recommended
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High-Risk Groups Certain factors id
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Diagnosis of Latent Tuberculosis In
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continually exposed to populations
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Administration of the Tuberculin Sk
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See “Two-Step Tuberculin Skin Tes
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See “Live-Virus Vaccines” under
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For more information on IGRAs and t
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Table 5: TARGETED TESTING FOR LATEN
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Treatment of Latent Tuberculosis In
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Policy Detailed information on the
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Window period prophylaxis is treatm
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Regimens Identify an appropriate re
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Dosages Once the appropriate regime
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Side Effects and Adverse Reactions
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If a patient reports to a healthcar
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Antituberculosis Drug Rifampin (RIF
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DOT is strongly encouraged for thos
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Table 7 describes the duration of t
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Alcoholism Alcohol-Related Treatmen
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Medication Administration and Pharm
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National Tuberculosis Controllers A
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24 CDC . “Recommendations for Use
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Diagnosis and Treatment of Latent T
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All children suspected or diagnosed
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Latent Tuberculosis Infection (LTBI
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History of BCG vaccination is not a
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Because of their higher specificity
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Table 3: COUNTRIES AND AREAS WITH A
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Treatment of Latent TB Infection (L
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For consultation regarding the trea
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Monitoring DOT is mandatory for INH
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For young infants, some experts rec
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TABLE 8: SIGNS AND SYMPTOMS OF PULM
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Treatment of Tuberculosis Basic pri
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Regime n 1 2 3 ❺ Table 10: FOUR T
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† 35 Table 11: DOSES*OF FIRST-LIN
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Monitoring Response to Treatment Ch
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Child Care and Schools: Children wi
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Other TB medications are not commer
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10 Centers for Disease Control and
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Case Management CONTENTS Introducti
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patient-centered approach to case m
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Alaska TB Program: Timeline for the
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For assistance with language issues
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Ascertain the extent of TB illness
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medical/health problem. The date of
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necessary to teach people how to ta
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Treatment Plan Components Recommend
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Implementation Activities To begin
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o Indicate the number of doses prov
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Review the status of the contact in
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For more information, see the “Di
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importance of continued treatment a
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5. Review information with the prov
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Completion of Therapy The case mana
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Case Closures Other than Completion
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Conduct a case management meeting o
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Biweekly (BIW) doses of TB medicati
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Use DOT with other measures such as
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It is important not to send a mixed
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Medical Orders Progressive Interven
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CDC. Module 9: “Patient Adherence
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36 New Jersey Medical School Nation
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75 CDC. Module 9: patient adherence
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Introduction Purpose A contact inve
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For roles and responsibilities, ref
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Decision to Initiate a Contact Inve
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chest radiographic findings that ar
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In general, a contact investigation
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Time Frames for Contact Investigati
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Circumstances unique to Alaska may
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Circumstances unique to Alaska may
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Activity Purpose Maximum Time Inter
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Infectious Period Determine the inf
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In general, for the purposes of con
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General Guidelines for Interviewing
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Healthcare workers should remember
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Index Patient with Positive Acid-Fa
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Index Patient with Negative Acid-Fa
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Contact Evaluation, Treatment, and
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Definition of abbreviations: HIV =
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Note: An IGRA may be used in place
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When to Expand a Contact Investigat
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Figure 7: EVALUATION, TREATMENT, AN
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CDC’s “Framework of Program Eva
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Definitions of abbreviations: AIDS
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elease assay; LTBI = latent tubercu
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officials to distinguish between di
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References 1 ATS, CDC, IDSA. Contro
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44 CDC, NTCA. Guidelines for the in
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Available Laboratory Tests Table 2:
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Table 3: PCR Testing Algorithm and
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Table 4: SPECIMEN COLLECTION METHOD
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5. If possible, send the specimen o
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Specimen Shipment There are three m
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Patient Education CONTENTS Introduc
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treatment, common side-effects of m
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Education Topics During the initial
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10. Explain the signs and symptoms
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Patient Education Materials Get th
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References 1 CDC. Module 4: treatme
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National Guidelines The following g
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Transfer Notifications CONTENTS Int
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For roles and responsibilities, ref
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Follow-Up Type When to Initiate Not
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Action Transfers Within Alaska Tran
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Page 361 and 362: Infection Control CONTENTS Introduc
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Page 365 and 366: Administrative Activities 13 Key ac
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Page 369 and 370: For regulations in your area, refer
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Page 375 and 376: Isolation To reduce disease transmi
Page 377 and 378: Table 4: CRITERIA FOR PATIENTS TO B
Page 379 and 380: When to Initiate Airborne Infection
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Page 387 and 388: Return to Work, School, or Other So
Page 389 and 390: Tuberculosis Infection Control in P
Page 391 and 392: Transportation Vehicles To prevent
Page 393 and 394: 7 CDC. Guidelines for preventing th
Page 395 and 396: Forms: Alaska State Public Health L
Page 397 and 398: ALASKA STATE PUBLIC HEALTH LABORATO
Page 399 and 400: Anchorage Alaska State Public Healt
Page 401 and 402: INDEX CASE INFORMATION Name: DOB: /
Page 403 and 404: CONTACT Name: Tuberculosis Contact
Page 405 and 406: Directly Observed Therapy (DOT) Cal
Page 407: B. Documents patient care activitie
Page 411 and 412: Treatment Summary for Active TB Nam
Page 413 and 414: Interjurisdictional Tuberculosis No
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Page 421 and 422: Latent Tuberculosis Infection (LTBI
Page 423 and 424: Alaska Tuberculosis Program 9210 Va
Page 425 and 426: Instructions for Collecting Sputum
Page 427 and 428: TB Case Management Information Requ
Page 429 and 430: Table 1: First-line anti-tuberculos
Page 431 and 432: Return the fax to the Drug Room (90
Page 433 and 434: Stock Orders: A small supply of
Page 435 and 436: TB/LTBI Medication Return Form Reas
Page 437 and 438: TB/LTBI Stock Medication Request FA
Page 439 and 440: TB Medication Dose Monitoring Regim
Page 441 and 442: TB Medication Dose Monitoring Regim
Page 443 and 444: ALASKA DEPARTMENT OF HEALTH AND SOC
Page 445: Tuberculosis Discharge Planning Che
Page 448 and 449: PART 2: 8. Have you ever been told
Page 450 and 451: Tuberculosis Treatment Contract Dep
Page 452 and 453: Statutes and Regulations Contents I
Page 454 and 455: Regulations Infection Control 7 AAC
Page 456 and 457: place of work is remote from patien
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(2) the child or a person acting on
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Glossary acid-fast bacilli (AFB): M
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eaction size on a later test, which
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disseminated TB: See miliary TB. dr
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immunocompromised and immunosuppres
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include medical history and TB symp
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thousands to millions of copies of
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secondary (TB) case: A new case of
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eproducing TB organisms from respir
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Alaska Tuberculosis Program Manual - Epidemiology - State of Alaska

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