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Mobile
Institutes
For

Nurses

The Regional

Medical Program and
the Tuberculosis

and Respiratory
Disease Association
of Western New York
operate a unique
training program ,
in respiratory
disease care.

Photos courtesy of Bedside Nurse

 
As a result of the consultation recommendations to the
first hospital, the TB and Health Society was asked to help
set up education programs for medical and paramedical
staffs. This has been done. In addition, all of the consulta-
tion recommendations have been carried out in this
hospital.

Other hospitals

At this writing the fifth and sixth hospitals have com-
pleted their consultation programs and are now in the
process of implementing the recommendations. Some of
these are:

* Provide increased medical supervision of the hospi-
tal’s intensive care unit. Develop a team of physicians
who will supervise this unit on a 24-hour basis.

¢ Obtain the full-time services of a physician well
trained in pulmonary disease. This staff member can
conduct in-service educational programs for hospital
staff members and supervise care of respiratory
patients.

* Increase in-service education for nurses in respiratory
therapy, using existing staff members and outside
consultants. In addition, recruit nurses with special
training in pulmonary disease to help direct the edu-
cational programs.

e Audit hospital medical records regularly (Peer Re-
view).

* Impose on both attending and house medical staffs
the responsibility of attending a minimum number
of medical education sessions in order to maintain
their status on the hospital staff.

* Institute 24-hour coverage by physicians in the
emergency room.

The consultation service is available free of charge to
any hospital in the Greater Detroit area. Each consulta-
tion program costs the Society approximately $600 to
cover expenses and honorariums.

Hospital administrators and medical education directors
in the hospitals which have undertaken the consultation
program have found the service valuable. The chairman
of the TB and Health Society’s respiratory disease com-
mittee states: “The success of the consultation service can
be measured by the fact that the hospitals that we have
worked with have implemented most of the recommenda-
tions made by the consultation team. After three yeats’
experience with this type of service, we sincerely recom-
mend it to other communities.” «

 

CuHartes R. KIESEWETTER has been executive director of the TB
and Health Society of Wayne County (Michigan) since 1965. Be-
fore that, he was executive director of the Montgomery County
TB and Health Association in Dayton, Ohio. Mr. Kiesewetter is
currently a member of the NIRDA Committee on Cooperation
with Federal Agencies. He is also a member of the Comprehensive
Health Planning Council of Southeastern Michigan. He is a past
president of the Mississippi Valley TB-RD Conference.

April 1972

 

People-Proof
Tuberculin

FOR THE PAST SEVERAL YEARS, the Diagnostic Skin Testing
Committee of the American Thoracic Society has been
working cooperatively with the producers of tuberculin skin
testing products, the Center for Disease Control (CDC),
and the National Institutes of Health (NIH) to see that all
PPD-tuberculin skin testing products used in testing for
tuberculosis are standardized and stable.

As the first step in accomplishing this goal, the
manufacturers produced large batches of PPD-tuberculin
that will last for many years, thus doing away with the
previous method of making many small batches that varied
in strength from batch to batch. In addition, studies in the
laboratory and in human subjects showed that a minute
amount of a detergent-like substance, Tween-80®, would
prevent adsorption of the tuberculin onto the inner surface
of the container and syringe (otherwise potency is reduced),
Also determined was exactly how much PPD-tuberculin
thus stabilized should be in each dose so the skin test
would be biologically equivalent to the standard PPD-S,
The Tween-80, in effect, makes the liquid tuberculin
“neople-proof” by markedly reducing the likelihood of losses
in potency when tuberculin is transferred to other containers
or when the syringe is filled long before it is used to
administer the test.

The final step toward the goal occurred January 18, 1972,
when the CDC Division of Biologics Standards called
together an ad hoc advisory committee to make recommenda-
tions to the DBS concerning the reported instability of the
tablet form of tuberculin. The committee reviewed the
available information and recommended that, within one
year, the tablet form be replaced by the liquid tuberculin,
containing Tween-80 or its equivalent; that it be biologically
equivalent to PPD-S in humans; and that during the interim
period, the tablet form—when used—should be used only
within 30 minutes after being put into solution and be
employed for the skin test immediately after the syringe is
loaded.

The committee consisted of Drs. Phyllis Q. Edwards,
Lydia Edwards, Michael L. Furcolow, Lee Reichman,
Gerard Wijsmuller, and Donald C. Kent, medical director
of the NTRDA, as chairman.

 

11
 

SUMMARY OF NONMEDICAL
PROGRAM

BUSINESS

SUNDAY/MAY 21
9:30 am/5:00 pm

ATS Council Meeting
9:30 am/5:30 pm

NRDC Membership Meeting/Observance of 60th Anniversary
a, J. MOWITZ, Ph.D., University Park, Pa., Speaker. W. F.
Roberts, Oakland, Cal., President, presiding.

WEDNESDAY/MAY 24
11:00 am/12:00 noon

ATS Business Meeting
4:00/4:30 pm

Annual Meeting of the Members of the NTRDA/J. H. BIDDLE,
Huntingdon, Pa., Chairman

THURSDAY/MAY 25

9:00 am/5:00 pm

Meetings of NTRDA Committees
FRIDAY/MAY 26

9:00 am’5:00 pm

NTRDA Board of Directors Meeting
7:00 pm

Organizational Meeting of Newly-Elected NTRDA Board of
Directors

GENERAL

SUNDAY/MAY 21
§:30/7:00 pm

OPENING SESSION/A. K. BENJAMIN, Kansas City, Mo., Con-
vener/J. H. BIDDLE, NTRDA Pres., Chairman

Invocation/REV. W. W. SMITH, Independence, Mo.

Welcome to Kansas City/MAYOR C. B. WHEELER, JR., Kansas
City, Mo.

Greetings/V. W. GRAY, California, Mo./W. A. WERNER, M.D., St.
Louis, Mo./R. L. ROBB, Topeka, Kan.

Presentation of Public Relations Awards/J. H. BIDDLE, NTRDA
Pres.

Introduction of 1972 Honorary Christmas Seal Chairman/J. C.
HARRISON, Helena, Mont.

introduction of Speaker/A. K. BENJAMIN, Kansas City, Mo.
James E. Perkins Lecture/STUART SYMINGTON, U.S. Senator
from Missouri.

14

7:00/8:00 pm

Reception/A Dutch treat social hour will immediately follow the
Opening Session.

MONDAY/MAY 22
4:30/7:00 pm

Awards Presentation and Reception/J. H. BIDDLE, NTRDA Pres.,
Chairman

Presentation of Will Ross Medal/
Presentation of Edward Livingston Trudeau Medal/

Dutch treat social hour/immediately following the Awards pres-
entation honoring the recipients of the medals.

SPECIAL INTEREST

TUESDAY/MAY 23
1:30 pm/5:00 pm

Presidents Talk It Over/J. H. BIDDLE, NTRDA Pres./J. C. HARRI-
SON, NTRDA Pres.-elect, Moderators

An opportunity for presidents of constituent associations and
the NTRDA to discuss mutual problems. By invitation from Mr.
J. H. Biddle to constituent presidents.

PUBLIC HEALTH/NURSING/
VOLUNTEER

MONDAY/MAY 22
(Note separate session for nurses Monday afternoon, May 22)
9:00/10:30 am

Transportation and the Environment: A Conflict in Priorities—
Can It Be Resolved? J. KIERAN, M.D., ATS Pres., Chairman

Transportation: A Key Factor in Environmental Control/Special
Guest, EDDIE ALBERT, Pacific Palisades, Cal.

The Need to Re-order the Nation’s Transportation Priorities/J. D.
KRAMER, Washington, D.C.

Rapid Transit in Small Cities/S. E. G. ELIAS, Ph.D., Morgantown,
West Va.

14:00 am/12:00 noon

The Smoking Dilemma—Iif We're Doing All Right, What's
Wrong?/S. M. AYRES, M.D., New York, N.Y., Chairman

The Smoking Problem-—-From a Psychiatrist’s Point of View/
E. M. PATTISON, M.D., Orange, Cal.

11:00 am/12:00 noon

TB Control Programs: Evaluation and Planning in the 1970’s/
Chairman to be announced

The New Tuberculosis Program Evaluation Measures/M. L.
ATKINSON, M.A., Atlanta, Ga.

Field Trial Experiences/(Speakers to be announced)
1:30/4:00 pm
(Break: 2:30-3:00 pm)

Program Idea Exchange for TB-RD Associations/Five separate
sessions, to be held concurrently.

TB Eradication: M@. DONALD HARMAN, Portland, Ore., Chairman
RD Control: TAYLOR R. COPPING, M.S., Richmond, Va., Chairman

Anti-Smoking: JAMES A. SWOMLEY, M.H.A., East Hartford,
Conn., Chairman

Air Conservation: K. W. GRIMLEY, M.S., Birmingham, Ala., Chair-
man

NTRDA Bulletin
  

   

IN WESTERN New York, teaching comes to the
nurse. At least, teaching respiratory care.

The program, devised by the Tuberculosis and Respira-
tory Disease Association of Western New York and the
Regional Medical Program (RMP) of the same area,
makes it possible to offer high-quality tuberculosis’ and
respiratory disease nursing care information to the nurses
of any community in the nine-county area served by RMP.
The nurses need only request it.

The content of each program is separately developed by
a planning committee, composed of the local nurses and
medical personnel requesting the institute, members of
the nursing staff of the RMP based in Buffalo, and the
TB-RD association. And, in order to make the one-day
institute even more individualized, at least one local physi-
cian usually attends the sessions.

Though the program varies from place to place, each

institute’s content deals to some extent with anatomy,
physiology, and pathophysiology; disease prevention; ad-
mission procedures, including diagnostic tests, X-rays,
and pulmonary studies; individual case histories; assess-
ment of the patient’s needs; development of a nursing
care plan; and. treatment procedures, covering such sub-
jects as the contribution of pulmonary function tests and
blood gas measurements, tracheostomy care, and rehabili-
tation and home care.

The tools used include slides, screens and projectors;
hospital bed demonstrations and equipment; and such
portable devices as a patient-operated nebulizer and a
liquid oxygen container to be carried on a_patient’s
shoulder.

Brochures describing a forthcoming institute are mailed
out to about 6,000 nurses some four to six weeks in ad-
vance to allow the nurses time to arrange for attendance.

Most of the institutes are held at public places—large
motels and community colleges, for example—rather than
at the local hospitals in order to offer the nurses con-
venient restaurant and transportation facilities.

The thousands of nurses throughout Western New
York who have attended the institutes (attendance for
each runs between two and three hundred) have voiced
their satisfaction through evaluation sheets passed out at
the end of the day’s sessions. In fact. so popular are the
institutes that they may be expanded into two- or three-
day affairs. «

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