Public health and hospital-based nursing intersection: Case study of drug-resistant tuberculosis patients.
Elize Pietersen, Kim Anderson, Yuri F van der Heijden
PMID 34990027WHAT IT FOUND
Public health nurses arranged transport, increased medication supplies, and supported hospital-community transitions for drug-resistant TB patients, but outcomes varied from cure to death.
Key findings
01Four selected drug-resistant TB patients had variable outcomes: Case A had suboptimal adherence during his last two hospitalizations, Case B died after 355 days on treatment, Case C died 145 days after absconding, and Case D achieved cure.
02When patients did not return from hospital leave, public health nurses visited them and arranged continued treatment or transport.
03Case D reported difficulty reaching the clinic in rain, and nurses increased his medication supply; he achieved cure.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The paper reports only four cases, so it cannot show what usually happens or whether nursing actions changed outcomes. Cases were selected because they had public health nurse care before and after hospitalization and extensive records, so they may not represent all drug-resistant TB patients. Data were gathered retrospectively from patient folders and healthcare worker notes, so patient views and unrecorded events may be missing. All selected cases were male, so the findings may not apply to female patients.
The easy way to misread this
Do not conclude that public health nursing caused cure or prevented death. This is a case study of selected patients with different outcomes, so it describes care processes rather than effectiveness.