New guide launched for nurses to manage Drug-Resistant Tuberculosis side effects
24 October 2018
The Hague, The Netherlands; Geneva, Switzerland, 24 October 2018 – The International Council of Nurses (ICN) today announced the launch of the ICN and Curry International TB Center Nursing Guide for Managing Side Effects to Drug-resistant TB Treatment at The Union’s 49th World Conference on Lung Health in The Hague.
This ICN/CITC guide was developed by nurses with experience in the clinical care and programmatic management of tuberculosis (TB) and drug-resistant tuberculosis (DR-TB) in both high- and low-resource settings. Nursing and DR-TB literature were reviewed to establish best practice nursing assessment and intervention guidance. More than 200 nurses caring for patients with DR-TB field-tested the guide in 11 countries and provided very favourable feedback confirming its broad applicability worldwide. Their feedback was used to inform the final content and format of this guide.
Patients on treatment for DR-TB face many challenges, most notably difficult side effects such as nausea, hearing loss and fatigue that may impact the patient’s quality of life, capacity to work and ability to continue activities of daily living. Recent studies have identified medication side effects as a major factor for patients stopping treatment. The 2018 WHO Global TB Report noted a continued crisis related to treatment outcomes for DR-TB with only 55% of patients successfully completing treatment.
Dr Carrie Tudor, Director of ICN’s TB/MDR-TB project pointed out that “The guide is a practical resource for nurses in inpatient, clinic and community settings who are caring for patients with DR-TB. It helps them to identify potential side effects and provides suggestions for nursing assessments and interventions to minimize the effects of side effects to treatment.”
Ann Raftery, Nurse Coordinator at Curry International Tuberculosis Center noted that “TB cure takes a long time. Nurses commonly see DR-TB patients daily for a period of many months for monitoring and treatment therefore are often the first to hear of a patient’s side effects during treatment. Having a resource available to them empowers the nurse to be able to help his/her patient.”
The guide is designed as a response to nurses’ requests for better resources. It is as a reference, so nurses can quickly: 1) identify symptoms that may indicate a side effect related to DR-TB treatment or antiretroviral medication; 2) assess for severity as well as other potential contributors; and 3) intervene appropriately to minimize patient discomfort, reduce side effect progression, and ultimately support successful treatment completion.
Nurses who field-tested the guide said that it “…gives a guided way of finding solutions to the side effects being experienced by the patients. It is easy to teach fellow members of staff and in my work setting it is a first of the kind…” (Nurse from Zambia). A nurse from Russia reported “I always keep the draft tool on my desk. When my patient has any complaints, I use it to choose the course of action. I try to help my patients cope with the side effects.” Another Russian nurse stated, “My patients have developed more trust, they now tell me about side effects as soon as they notice any, without waiting too long until the symptoms become more pronounced.”
The guide will soon be available in Russian, Chinese, Bahasa Indonesia and Spanish as well.
ICN’s MDR-TB project aims to support the World Health Organisation end TB strategy by building global nursing capacity in the prevention, care and treatment of TB. This is achieved by training experienced nurses to cascade information to nursing colleagues and other health workers with the purpose of making improvements to patient care delivery. The development of this guide was supported by a United Way Worldwide grant, made possible by the generosity of the Lilly Foundation on behalf of the Lilly MDR-TB Partnership and by the Stop TB Partnership’s TB REACH initiative funded by the Government of Canada and the Bill & Melinda Gates Foundation. CITC/UCSF is funded through the US Centers for Disease Control and Prevention (CDC) Cooperative Agreement NU52PS910163-01-00 TB REACH.
Note for Editors
The International Council of Nurses (ICN) is a federation of more than 130 national nurses’ associations representing the millions of nurses worldwide. Operated by nurses and leading nursing internationally, ICN works to ensure quality care for all and sound health policies globally.
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