Diana Fortune RN, BSN TB Program Manager New Mexico TB ETN/PEN 2012
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Transcript of Diana Fortune RN, BSN TB Program Manager New Mexico TB ETN/PEN 2012
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Diana Fortune RN, BSNTB Program Manager
New Mexico
TB ETN/PEN 2012
Doorway to a New EraPharmacists as Public Health Partners
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NM Pharmacist Association contacted TB program – Considering prescriptive authority for pharmacists to place TSTs◦ Regulatory agencies
Medical Board Nursing Board Department of Health
TB Program
NM pharmacists large range of prescriptive authority◦ Lack of accessible health care in many areas
November 2010
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Background on New Mexico
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Land of Enchantment: Fun Facts Do NOT need passport
State Question?◦ Red or Green
Breaking Bad◦ Filmed here!
5th largest state – land mass◦ 121,000 sq miles
6th LEAST populated◦ 2 million
1912 – bilingual gov’t◦ No official language
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Decrease public health $$
Lack of nursing staff
Remote areas of State
Barriers to accessible TSTs
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Newspaper Coverage……
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Prescriptive Authority◦March 7, 2011 – protocol was added for Pharmacist to
administer TSTs (regulation16.19.26.12) Initially indicated the pharmacists view
CDC “Mantoux Tuberculin Skin Test Video for their training…
NM Board of Pharmacy
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Met on June 2, 2011◦ TB Program (TBP)◦ Pharmacist Association◦ Board of Pharmacy
NM TBP leading roll in education of pharmacists TST training◦ Press release on August 31, 2011◦Webinar – Heartland National TB Center; Sept 8, 2011
Understanding the TST: A Primer for Non-TB Staff (Diana Fortune) Open to other states – 61 registered attendees Required for NM Pharmacists to view prior to TST Practicum
Archived @ Heartland & NM Pharmacists Association website
Official collaboration begins…..
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Division of Services……
Pharmacists Testing Public Health Testing
Low-Risk Population (TSTs)◦ Pharmacists to test
School Work Change of immigration status
High-Risk Populations◦ Tested @ public health dept.
TB suspects Contacts Immune compromised
HIV TNF-alpha blockers Other immune compromised
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In addition…… TST Health History◦Utilize DOH standardized form◦Accurate reading of TST
CDC cut-points Referral of +TST◦ CXR prior to health dept referral◦May refer to PCP
Refer high-risk clients to public health◦Do not test at pharmacy
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CEU provided by NM Pharmacist Association
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September 25, 2011
Five TST practicums held since September
Total of 50 pharmacists attended
Several hundred TSTs performed: < 5 positive TSTs
TST Practicums…..
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Informal by NM Pharmacist Association◦ Participating pharmacists indicated a confidence in their
ability to provide this service to the public
◦Around 100 TST applied no positive TSTs (at time of survey)
Project Evaluation
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“Outcomes of a Pharmacist Performed Tuberculosis Testing Initiative in New Mexico”◦ University of New Mexico College of Pharmacy
Objectives◦ Provide a qualitative assessment of the TSTs performed by pharmacists
& identify potential benefits of providing TST at community pharmacies◦ Evaluate outcomes of TB testing performed in a community pharmacy
setting◦ Describe the standardized training for pharmacists to accurately place,
read and interpret the TST.
Formal Project Evaluation
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• Increased access to TSTs
• Pharmacists referrals when clients presented with signs or symptoms of TB disease
• In the era of declining public health dollars • all avenues of collaboration to ensure sustained TB
prevention efforts should be explored
In conclusion: