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theme 4: the nursing role in tuberculosis
treatment
Throughout history nurses have contributed significantly
to the treatment and reduction of tuberculosis. They have
been key members of the health-care team and have
undertaken various activities. Many areas have tuberculosis
nurse specialists and their roles vary depending on the area
in which they work. Some areas have community tubercu-
losis teams which include nurse specialists and will under-
take home visits themselves, while other areas will have
small teams of hospital-based nurse specialists who require
the support of district nursing teams for their home-based
patients. This support may include the district nursing team
taking on the role of direct observation. It can, however, be
a popular belief among some district nursing staff that they
are ‘not allowed’ to dispense and supervise oral medica-
tions. There is also the argument that if they give medica-
tion to these patients then they would have to do this for
everyone. This is an invalid argument as tuberculosis is a
communicable disease and if left untreated could infect an
average of 10-15 people a year (DH, 2004).
Communication is an integral part of the nursing role
and when Dick et al (2004) looked at the implementation
of an in-service education programme for primary care
staff in South Africa, they identified that many tubercu-
losis patients were failing to complete their tuberculosis
treatment and they concluded that poor rapport between
health staff and patients was a major contribution toward
this. They therefore identified that good communication
was a priority in tuberculosis care. Williams et al (2008)
reiterate this point by declaring that good communication
is needed between all members of the multi-disciplinary
team when caring for patients with tuberculosis.
theme 5: the integration of teams
(in relation to tuberculosis treatment)
The action plan for tuberculosis (DH, 2004) states that
there should be local multi-disciplinary teams with a
common focus. In the context of this review integration
of teams would imply the district nursing teams working
together with the tuberculosis specialist nurses. Davies
(2003) has said that the input of district nurses is greatly
valued in supporting tuberculosis nurses. District nursing
teams holistically assess their patients in order to identify
individual needs and provide information and support
aiming to make their patients as independent as possible.
Griffith and Tengnah (2005) also reason that as tuberculosis
is an infectious disease, timely interventions are required
when addressing treatment. This then requires a coordi-
nated approach by all health professionals and the relevant
public health agencies.
Two separate pieces of research were undertaken by the
same authors (Craig et al, 2007; 2008) looking at the subject
of integration in tuberculosis care. In the first, a prospective
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