Date of Award

Spring 5-25-2018

Document Type

Doctor of Nursing Practice Final Manuscript

Degree Name

Doctor of Nursing Practice

Department

Nursing

First Advisor

Kathy James, DNSc, APRN, FAAN

Second Advisor

Kimberly Woodruff, MD, MPH

Abstract

Around 13 million people in the United States have latent tuberculosis infection (LTBI) with a 5-10% chance of developing active tuberculosis (TB) in their lifetime if not treated (Center for Disease Control, 2015). At a University Student Health Center (SHC), there is a matriculation requirement for TB testing for students that screen as high risk. Many students have these testing requirements performed at outside clinics, including foreign clinics, and follow-up regarding education about LTBI and treatment recommendations was often missing. The purpose of this evidence-based practice (EBP) project was to increase follow-up, education, and treatment options after diagnosis of LTBI. Students presenting with LTBI to the SHC received a standardized message through the secure patient-portal regarding their diagnosis, treatment options and education about LTBI. It asked them to follow-up with a message, telephone call or in-person appointment. Prior to the intervention, most students with LTBI received no follow-up, and after the intervention 100% of new cases received follow-up. A total of 42 students were sent a secure message, 31 read the secure message and 13 of those students contacted the health center or an outside provider for further follow-up. Out of those 13 students, 7 started treatment for LTBI. The goals of this study were to increase follow-up and education around LTBI, and increase the number of students choosing treatment, all of these outcomes were met. The secure message system was a reliable way to contact students regarding their diagnosis and education around LTBI.

Keywords: Latent tuberculosis, interferon-gamma release assay, tuberculin skin test, mycobacterium tuberculosis

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