Still 11 .......... ie ns u es or urses 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 Nrirse 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 eo em roo hospital. Other hospitals At this writing the fifth and sixth hospitals have corn- u ercu n pleted their consultation programs and are now in the process of implementing the recommendations. Some of these are: FOR 'I-IFE PAST SEVERAI., YEARS, the Diaanostic Skin Testing 0 Provide increased medical supervision of the hospi- Committee of the American Thoracic Society has been tal's intensive care unit. Develop a team of physicians working cooperatively with the producers of tuberculin skin who will supervise this unit on a 24-hour basis. testiii,, products, the Center for Disease Control (CDC), * Obtain the full-time services of a physician well and the National Institutes of Health (NIH) to see that all trained in pulmonary disease. This staff member can PIID-tLIherculin skin testing products used in testing for conduct in-service educational programs for hospital tuberculosis are standardized and stable. staff members and supervise care of respiratory As the first step in accoi-nplishin.- this -oat, the patients. manufacturers produced large batches of PPD-tuberculin o Increase in-service education for nurses in respiratory thtt will last for many years, thus doing away with the therapy, using existing staff members and outside previous method of making many small batches that varied consultants. In addition, recruit nurses with special in strength from batch to batch. In addition, studies in the training in pulmonary disease to help direct the edu- laboratory and in human subjects showed that a minute cational programs. amount of a detergeiit-like substance, Tween-80(g, would o Audit hospital medical records regularly (Peer Re- prevent idsorption of the tuberculin onto the inner surface view). of the container and syringe (otherwise potency is reduced). 9 Impose on both attending and house medical statTs Also determined was exactly how much PPD-tuberetilin the responsibility of attending a minimum number thus stabilized should be in each dose so the skin test of medical education sessions in order to maintain would be biologically equivalent to the standard PPD-S. their status on the hospital staff.. The Tween-80, in effect, makes the liquid tuberculin * institute 24-bour coverage by physicians in the llpcople-proof" by markedly reducing the likelihood of losses emergency room. in potency when tuberculin is transferred to other containers The consultation service is available free of charce to or when the syringe is filled long before it is used to anv hospital in the Greater Detroit area. Each consulta- tdminister the test. tion program costs the Society approximately $600 to The final step toward the aoal occurred January 18, 1972, cover expenses and honorariums. when the CDC Division of Bioloc@ics Standards called Hospital administrators and medical education directors to(,ether an ad hoc advisory committee to make recommenda- in the hospitals which have undertaken the consultation tions to the DBS concerning the reported instability of the program have found the service valuable. The chairman tablet form of tuberculin. The committee reviewed the of the TB and Health Society's respiratory disease corn- tvtil@ible information and recommended thit, within one mittee states: "The success of the consultation service can yeit-, the tablet form be replaced by the liquid tuberculin, be measured by the fact that the hospitals that we have containing., Tween-80 or its equivalent; that it be biologically workecl with have implemented most of the recommend,,t- equivalent to PPD-S in humans; and that dlirin.- the interim tions made by the consultation team. After three years' period, the tablet form-when used-shoul(I be used only experience Nvith this type of service. we sincerely recent- within 30 minutes after being put into solution and be niend it to other communities.@@ employed foi.- the skin test immediately after the syriiioe is reacted. The coi-ninittee consisted of Drs. Phyllis Q. Edwards, Cli@%Rf-f@s R. Kii-Sf:Wi@-fTER has been executive director of the TB I-y(lia Edwirds, Michael L. FLircolow, Lee Reichman, @ind He@tith Society of W@tyne Countv (Michig@in) since 1965. Be- fore that, he was executive director Iof the Mont-oi-nery County Ger-,ii-cl Wijsmuller, and Donald C. Kent, medical director TB and J4ealth Association in Dayton, Ohio. Mr. Kiesewetter is of the NTRDA, as chairman. Currently Lt nieinhei- of the NTRDA Committee on Cooperation with Federal A,,encies. He is also a mernbet- of the Comprehensive He,ilth PlinninL, Council Of SOLIthe',tSteFn Michi,,,,in. He is a past president of the klississippi V@illey TB-RD Conference. April 1972 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 SUMMARY OF NONMEDICAL Presentation of Will Ross Medal/ PROGRAM Presentation of Edward Livingston Trudeau Medal/ Dutch treat social hour/immediately following the Awards pres- entation honoring the recipients of the medals. BUSINESS SPECIAL INTEREST SUNDAY/MAY 21 TUESDAY/MAY 23 9:30 am/5:00 PM 1:30 pm/5:00 PM ATS Council Meeting Presidents Talk It Over/J. H. BIDDLE, NTRDA Pres./J. C. HARRI- 9:30 am/'5:30 PM SON, NTRDA Pres.-elect, Moderators NRDC Membership Meeting/Observance of 60th Anniversary An opportunity for presidents of constituent associations and R. J. MOWITZ, Ph.D., University Park, Pa., Speaker. W. F. the NTRDA to discuss mutual problems. By invitation from Mr. Roberts, Oakland, Cal., President, presiding. J. H. Biddle to constituent presidents. WEDNESDAY/MAY 24 PUBLIC HEALTH/NURSING/ 11:00 am/12:00 noon VOLUNTEER ATS Business Meeting MONDAY/MAY 22 4:00/4:30 PM (Note separate session for nurses Monday afternoon, May 22) Annual Meeting of the Members of the NTRDA/J. H. BIDDLE, Huntingdon, Pa., Chairman 9:00/10:30 am THURSDAY/MAY 25 Transportation and the Environment: A Conflict in Priorities- Can It Be Resolved? J. KIERAN, M.D., ATS Pres., Chairman 9:00 am/5:00 PM Transportation: A Key Factor in Environmental Control/Special Meetings of NTRDA Committees Guest, EDDIE ALBERT, Pacific Palisades, Cal. FRIDAY/MAY 26 The Need to Re-order the Nation's Transportation Priorities/J. D. KRAMER, Washington, D.C. 9:00 am,,15.00 PM Rapid Transit in Small Cities/S. E. G. ELIAS, Ph.D., Morgantown, NTRDA Board of Directors Meeting West Va. 7:00 PM 1 1:00 am/i 2:00 noon Organizational Meeting of Newly-Elected NTRDA Board of The Smoking Dilemma-If We're Doing All Right, What's Directors Wrong?/S. M. AYRES, M.D., New York, N.Y., Chairman The Smoking Problem-From a Psychiatrist's Point of View/ GENERAL E. M. PATTISON, M.D., Orange, Cal. 1 1:00 am/1 2:00 noon SUNDAY/MAY 21 TB Control Programs: Evaluation and Planning in the 1970's/ 5:30/7:00 PM Chairman to be announced OPENING SESSION/A. K. BENJAMIN, Kansas City, Mo., Con- The New Tuberculosis Program Evaluation Measures/M. L. vener/J. H. BIDDLE, NTRDA Pres., Chairman ATKINSON, M.A., Atlanta, Ga. Invocation/REV. W. W. SMITH, Independence, Mo. Field Trial Experiences/(Speakers to be announced) Welcome to Kansas City/MAYOR C. B. WHEELER, JR., Kansas 1:30/4:00 PM City, Mo. (Break: 2:30-3:00 pm) Greetings/V. W. GRAY, California, Mo./W. A. WERNER, M.D., St. Program Idea Exchange for TB-RD Associations/Five separate Louis, Mo./R. L. ROBB, Topeka, Kan. sessions, to be held concurrently. Presentation of Public Relations Awards/J. H. BIDDLE, NTRDA TB Eradication: M. DONALD HARMAN, Portland, Ore., Chairman Pres. Introduction of 1972 Honorary Christmas Seal Chairman/J. C. RD Control: TAYLOR R. COPPING, M.S., Richmond, Va., Chairman HARRISON, Helena, Mont. Anti-Smoking: JAMES A. SWOMLEY, M.H.A., East Hartford, Introduction of Speaker/A. K. BENJAMIN, Kansas City, Mo. Conn., Chairman James E. Perkins Lecture/STUART SYMINGTON, U.S. Senator Air Conservation: K. W. GRIMLEY, M.S., Birmingham, Ala., Chair- from Missouri. man 14 NTRDA Bulletin NOW, IN WESTERN NEW YORK, teaching comes to the nurse. At least, teaching respirator-,, care. The program, devised by the Tuberculosis and Respira- tory Disease Association of Western ',\Ie%v York and the Regional Medical Program (R.NIP) of the same area, makes it possible to offer high-quaflt@, 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. Ile 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 la 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 pathophysiolo2y; disease prevention; ad- mission procedures, includin@ dia--nos6c tests, X-ravs, and pulmonary studies; individual case histories; assess- ment of the patierit's needs; den-eloprnent of a nursing care plan; and treatment procedures, covering such sub- jects as the contribution of pulmona@. function tests and blood gas measurements, tracheostomv care, and rehabih- o( t@on and home care. The tools used include s@des, screens and projectors; hospital bed demonstrations and equipment; and such portable devices as a patient-operated nebu@zer and a liquid oxygen container to be carried on a patient's shoulder. Brochures describing a fortliconLin2 institute are mailed out to about 6,000 nurses some four to six weeks in ad- vance to allow the nurses time to arran2@ for attendance. Most of the institutes are held at public places-larle motels and community colleces, 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 York who have attended the institutes (attendance for each runs between two and three I)undred) 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. <(