Management of latent tuberculosis infection (LTBI) is a public health problem and a challenge for the control of tuberculosis infection (TB) in the U.S. One of the strategies to eliminate TB is through the detection and treatment of LTBI. The old regimen of isoniazid (INH) daily for 9 months has been updated. The new regimen recommends rifampin every day for 4 months and isoniazid plus rifapentine (3HP) one day per week for three months. The purpose of the doctor of nursing practice (DNP) project was to systematically review data on initiation and completion rates of LTBI treatment regimens in the general population, who reside in Northeastern San Francisco Bay Area California and to improve medication initiation and completion rates for LTBI. In 2 years, a report from January 1st, 2017– December 31st, 2018, the project area reported from 28,609 screened patients, only 1,987 cases were positive and by systemic sampling 1,112 positive cases were included in our study. The data collection shows that there were 38% male (n=421) and 62% female (n=691), among 1,112 patients only 49% (n=548) completed the treatment and 15% (n=166) were not initiated treatment. There were significant differences in completion rates between the traditional INH treatment for 9 months and 3HP for 3 months. The DNP quality improvement project found that 79% of LTBI patients who were given the 3HP for 3 months completed their treatment. LTBI patients who were given INH, only 58% have finished their treatment. Even though the 3HP has a better completion rate of 79%, only 8% of LTBI patients were given 3HP. The project result was significant and disclosed the need for increased health care providers, leadership engagement, motivation, and regulation of practice guidelines. The outcome of the project was to improve the current practice of LTBI and use updated evidence-based guidelines for LTBI program management to control TB.
|Advisor:||Farey, Krista, Wyckoff, Mary|
|School:||Samuel Merritt University|
|School Location:||United States|
|Source:||DAI-B 82/4(E), Dissertation Abstracts International|
|Keywords:||Tuberculosis, Latent tuberculosis infection, Isoniazid, Rifampin, Rifapentine, California|
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