Developing nursing practice as part of the collaborative TB control programme, Tomsk, Siberia

Area of Science:

• Public Health
• Nursing Practice
• Infectious Disease Control

Background:

• The Tomsk Oblast' Tuberculosis Services (TOTBS) in Russia required preparation for a World Health Organization (WHO)-style TB control program.
• Nursing roles and training needs within the TOTBS were assessed to align with international TB control standards.

Purpose of the Study:

• To prepare TOTBS nurses for the implementation of a WHO-style TB control program.
• To identify and address nursing practice gaps and training needs within the TOTBS.

Main Methods:

• Nursing services and training needs were evaluated through site visits, interviews, and staff discussions.
• Training focused on the WHO Directly Observed Treatment, Short-course (DOTS) strategy, patient education, and defaulter tracing.
• Nurse attitudes and treatment completion rates were assessed post-training.

Main Results:

• 53 out of 165 TB cases initiated DOTS on an ambulatory basis.
• Improved patient compliance and successful treatment completion were observed.
• No patients were lost to follow-up, with defaulting patients returning to treatment promptly.

Conclusions:

• Key obstacles included resistance to change, low morale, heavy workloads, and staff shortages.
• Motivation and practice improvements were achieved by setting attainable targets for nurses.
• Enhanced nursing education and reliable medication supply contributed to better TB treatment outcomes.