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Project connects nurses tending to TB patients

ALBUQUERQUE, N.M. — Tuberculosis is a complex illness that requires public health nurses to visit patients daily for at least six months, ensuring they take a multi-drug cocktail of antibiotics.

The nurses who provide direct care to TB patients work at 54 state Department of Health clinics scattered across New Mexico.

State health officials said Tuesday they are teaming up with the University of New Mexico’s Project ECHO, which uses sophisticated videoconferencing tools that give health professionals in remote areas access to a team of specialists.

Nurses who treat TB patients will meet by video with a team of physicians each month to discuss difficult cases and share their experiences with other nurses, said Dr. Bruce Struminger, an associate director of Project ECHO.

“The whole purpose of Project ECHO is to create a community of learning and practice,” he said. “When some of these complicated cases come up, they can be presented and the learning can be shared across the network of public health nurses.”

The system also allows participants to share patient records, including lab tests and X-rays, Struminger said.

In the past, Health Department personnel relied on telephone conference calls to support nurses, he said.

Tuberculosis is a bacterial disease that attacks the lungs, causing symptoms that include a persistent cough, weight loss, fatigue and fever.

About 50 new cases of TB are reported in New Mexico each year. The airborne disease can be transmitted when a person with symptoms coughs or speaks.

State health officials also treat 400 to 600 New Mexicans each year with latent TB, meaning their bodies are infected with the bacteria, but they don’t show symptoms.

Christy Silles, a Health Department nurse in Carlsbad, was one of about 25 public health nurses who received training this week at the Project ECHO building on the UNM campus.

Treating tuberculosis is difficult and time-consuming, often requiring daily visits to a patient’s home, Silles said.

“When they are infectious, we do home visits,” Silles said Tuesday following a news conference where the new program was announced. “We have to witness them take the medication.”

Silles said she hopes Project ECHO will provide her with better support and training. “We’ll also be able to collaborate with other nurses,” she said.

UNM’s Project ECHO was launched in 2003 to expand the reach of doctors treating hepatitis C. Today, the model is used to treat dozens of complex illness and has expanded to 36 sites in the U.S. and eight in foreign countries.

The monthly videoconferences also will allow TB experts to offer nurses brief training seminars on topics such as new medications and treatments, Struminger said.

“There’s a need for retraining all the time because new public health nurses are joining the workforce, probably every month,” he said.