Farley, PhD, MPH, NP, FAAN Associate Professor | Johns Hopkins University School of Nursing, Adjunct Associate Professor | University of KwaZulu Natal (UKZN), South Africa. Adult Nurse Practitioner | JHU School of Medicine
We will be responsible for initiating and monitoring treatment of drug-resistant TB (DR-TB) and paediatric patients, MDRTB patients with complications, co morbidities, or those who live near the unit. The centralised unit will support and advise the provincial TB Directorate regarding the clinical management of DR-TB in the province. Provincial Level:
The centralised DR-TB unit is also known as the “Provincial Centre of Excellence”. Each province has at least one hospital that is a specialised unit for DR-TB. This hospital will take a supporting and supervisory role for the MDR-TB outpatient programme in each province, and as the centre of excellence, provide technical advice to the decentralised MDR-TB sites. Functions of the Centralised DR-TB Unit:
• Initiating treatment of all DR-TB cases after appropriate assessment;
• Admitting DR-TB cases from the geographic area around the unit;
• Ensuring hospitalisation of all XDR-TB cases until there are two successive negative
TB cultures;
• Assessing all DR-TB patients attending the clinic each month;
• Providing DOT to all DR-TB patients attending the unit each day;
• Recording and reporting to the provincial Department of Health;
• Providing ongoing training, support and supervision for all the facilities in the
province;
• Providing social support, rehabilitation, educational and skills building programmes for
patients;
• Providing education and counseling to all patients admitted in hospital;
• Preparing a discharge plan for all patients and ensuring effective down referrals;
• Monitoring DR-TB patients post discharge until completion of treatment and two years
post treatment completion;
• Monitoring rational usage of second-line drugs and ancillary drugs for side effects
management;
• Establishing and maintaining functional clinical management teams;
• Compiling monthly, quarterly, six-monthly and annual reports of DR-TB patients started
on treatment, their culture conversion and outcomes;
• Providing technical assistance and capacity building to decentralised DR-TB units,
and feeder clinics on management of DR-TB; and
• Arranging patients’ evaluations at provincial patient review committees.
