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TB Notes Newsletter

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No. 3, 2010


Member Highlights: New Members of the Conference Planning Workgroup

In this issue, we highlight the three new members of the TB ETN Conference Planning workgroup: Mabel Smith-Duffus, Marcee Mortensen, and Sandra Bible.

Mabel Smith-Duffus, RN, MSNMabel Smith-Duffus, RN, MSN, is the Director of Education / Employee Health, and is in charge of infection control for the Treasure Coast Hospice in Stuart, Florida. Her employer provides end-of-life and palliative care to persons in the community with advanced illness. The populations served by the hospice include cancer patients as well as patients with other advanced disease such as pulmonary disease, HIV/AIDS, Alzheimer’s, stroke, and others.

In addition to her MSN and RN degrees, Mabel is a Licensed Health Care Risk Manager (LHCRM). Her job responsibilities include developing infection control policies and procedures, conducting new employee orientations, handling employee health issues, carrying out risk management activities with corrective actions, and providing infection control education and management. One of the most recent programs Mabel developed is a pediatric palliative care program, which addresses the special infection control challenges related to the pediatric population in the hospice setting, as well as the care of infants infected with TB and/or HIV. She also developed an in-house protocol and training for the management and care of veterans with latent TB infection after discharge from VA hospital to hospice.

In addition, Mabel has conducted a variety of educational programs, including a clinical infection control field study for new devices as well as other infection control related issues. In addition, she recently developed an in-house “biggest loser” program as part of the hospice’s wellness program; this is an ongoing process.

Mabel is a member of the Conference Planning workgroup, where she is currently working on the energizer committee. She first learned about TB ETN through an online search. Since that time she has joined TB ETN to learn “best practices” as they relate to TB and to learn about cutting-edge technology as it relates to the care and management of persons with TB infection.

In the next couple of years, Mabel would like to see TB ETN increase community awareness about latent TB infection and TB disease, TB signs and symptoms, and treatment; initiate community involvement in reducing the incidence of TB; and increase funding for community education to include the private sector.

In Mabel’s spare time she enjoys kick boxing, yoga, and Pilates. She is also passionate about helping children, and working with volunteer organizations such as Big Brothers and Sisters.

Marcee W. MortensenMarcee W. Mortensen, BS, CHES, is a Tuberculosis Health Educator for the Utah Department of Health. Marcee earned her bachelor of science degree in public health education from Brigham Young University in August 2008; she will graduate with a master’s degree in public health in April 2011.

The Utah Department of Health Tuberculosis (TB) Control Program collaborates with local health departments and community partners in working towards the elimination of TB in Utah.  Over the last 10 years, morbidity has declined, high-risk groups have been targeted for testing, and knowledge of TB in the community has increased through educational outreach programs that are both linguistically and culturally appropriate. The TB Program continues to collaborate with community-based organizations to expand services and to fill potential gaps in current services.

Marcee is currently employed part-time at the Utah Department of Health as a TB health educator for the Treatment and Care Program, and attends graduate school full-time.  As the health educator, her job responsibilities include, but are not limited to 1) providing TST trainings throughout the community, 2) managing and updating the TB Program website, 3) serving as a member of Utah’s World TB Day Conference Committee, 4) acting as a resource person, 5) evaluating Utah’s biannual TB Cohort Review, 6) serving as Utah’s focal point for both TB ETN and TB PEN, 7) serving as Utah’s Human Resource Development Coordinator (HRDC), and 8) assisting with refugee health responsibilities when needed.

A large part of Marcee’s job is providing TST trainings within the community. The training includes three main elements: 1) watch a CDC training video entitled “Mantoux Tuberculin Skin Test,” 2) practice administering a TST (using saline), and 3) practice reading a TST (using palpable TB practice arms). Between September 1, 2009, and June 30, 2010, she trained 114 individuals to place and read the Mantoux tuberculin skin test.

The most recent product that Marcee assisted in developing is the revision of the Utah Department of Health Tuberculosis Provider Guide. The original Provider Guide was developed in 2003; the revised Guide was made available in 2009.

Marcee learned of TB ETN from her Program Manager, Cristie Chesler, upon her hire in August 2008. She then joined TB ETN to collaborate with other TB health educators in regard to trainings and educational products. “I also greatly enjoy attending the annual TB ETN Conference,” Marcee explained. She is a member of the TB ETN Conference Planning workgroup. “I joined the workgroup so as to try something new and enhance my conference planning skills; joining the workgroup was also an opportunity for me to meet and work with new people,” stated Marcee.

In the next couple of years, Marcee hopes that TB ETN memberships will continue to increase, especially among international members. She also hopes the TB ETN workgroups can increase their memberships and ultimately increase participation. “Increased membership and workgroup participation can only improve TB ETN (trainings, resources, educational products, etc.),” Marcee explained.

In addition to Marcee’s TB-related daily responsibilities, her other public health interests include sexual health, social marketing, and public administration. Marcee added, “Whenever I am not working or studying, I simply enjoy spending time with my family.”

Sandra P. Bible, MA, BSNSandra P. Bible, MA, BSN, is an Assistant Program Specialist and Public Health Nurse for the Los Angeles County Department of Public Health. She holds an MA degree in health science focused on administration and education and a BS degree in nursing, both from California State University.

The County of Los Angeles has nearly 10.3 million residents, 3 million of whom are uninsured. Los Angeles County (LAC) is divided into eight Service Planning Areas (SPAs), supporting 11 public health clinics, and there are three county hospitals that care for patients with TB.  The County is a major port of immigration and a resettlement destination for large numbers of immigrants and refugees. The LAC Tuberculosis Control (TBC) Program receives reports of TB cases and suspects from 116 private hospitals, one VA hospital, and many, many private physicians. There are 30 labs that perform some level of TB testing within Los Angeles County.

Sandra’s job responsibilities include 1) providing leadership to the health education unit; 2) serving as the designated focal point for the Human Resource Development Planning (HRDP) Committee; 3) providing TB technical expertise, TB education and training materials, and in-service training on TB basics (TB 101); 4) serving as point person for compiling TB data for Program Collaboration and Service Integration activities; 5) providing advocacy to community based organizations and the private sector, as well as planning for World TB Day, as a member of the TB Coalition and TB Coalition Planning Committee; 6) serving on the TB Planning Council, and co-chair of the Private Medical Doctors (PMD) TB Education and Outreach Workgroup; and 7) serving as Wellness Coordinator for the LAC TBC Program.

The most recent products that Sandra has developed, in collaboration with the HRDP Committee, are two brochures specific to LA County on latent TB infection and active disease. The English versions of the brochures were recently finalized by the HRDP and External Relations Dept. of LAC and are posted on their TBC website. They plan to have the brochures translated into four different languages.

Sandra initially heard about TB ETN from supervisors at TBC when she joined the staff in 2005. She joined TB ETN the same year, when she was appointed as the focal point for the HRDP. After being a member for several years, she wanted to become more engaged with TB ETN. She enjoys sharing the benefits she has received with others in the Health Education Unit and with other TBC staff. “I utilize the materials throughout the year as a point of reference,” Sandra stated. Sandra hopes that TB ETN can continue to evolve as a leader of training for more Public Health Nurses, Health Educators, and others involved in TB education and training

Sandra’s hobbies include healthful cooking, biking, and hiking. “I enjoy cooking healthy food and making it simple, wholesome, and delicious, and promoting the benefits of healthy eating to others,” Sandra explained. She’s also a Team-In-Training participant with the Leukemia, Lymphoma, and Myeloma Society and trains every Saturday; she will take part in a biking event on November 20 in Tucson, Arizona.

If you’d like to join Mabel, Marcee, and Sandra as a TB ETN member and take advantage of all TB ETN has to offer, please send an e-mail requesting a registration form to You can also send a request by fax to 404-639-8960 or by mail to TB ETN, CEBSB, Division of Tuberculosis Elimination, CDC, 1600 Clifton Rd., N.E., MS E10, Atlanta, Georgia 30333 or, if you would like additional information about the TB Education and Training Network.

—Reported by Regina Bess
Div of TB Elimination

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Program Highlight: TB Update and Tuberculin Skin Testing Practicum for Nurses

In 2007, the Colorado Department of Public Health and the Denver Metro TB clinic partnered to develop a TB update and skin testing practicum for nurses. Until that time there was no TB training available for health care providers anywhere in the state. Both state and local health departments frequently fielded calls from providers at local hospitals, long term care facilities, home care agencies, and correctional facilities with basic TB and skin testing questions, and patients were often sent to public health clinics with skin tests that were placed or read incorrectly.

The state and local health department collaborated to develop a course to train health care providers on the basics of TB and correct tuberculin skin test (TST) placement and reading. Using materials from the Curry Center and CDC, course objectives and a curriculum were developed. By the end of the course, participants are able to express an increased and updated knowledge of TB infection and TB disease and demonstrate their skill in placing and reading the TST. Teaching methods include lecture, DVD/video, discussion and a hands-on practicum portion where students place skin tests on each other under the supervision of experienced TB outreach workers and practice reading TB skin tests on mannequins. A new learning tool that was recently incorporated into the class is an audience participation system. Each participant gets an electronic device that quickly records each person’s answer to questions during the pre-test and post-test. This provides immediate feedback on students’ understanding of important topics during the course; subsequent courses will be adapted to cover some of the knowledge gaps that were encountered. The class is held quarterly from 12:30 pm to 5 pm, with light snacks provided; the cost is $30, and participants receive 3.5 CEUs, a CDC skin testing DVD, and a packet of educational materials.

Since June 2007, 12 classes have been held and 258 individuals have been trained. Participants attend from around the Denver Metro area as well as from many other cities around the state, some traveling as long as 6 hours to the course.

Collaboration between state and local TB control programs can lead to successful training and education opportunities that benefit patients and health care providers from a variety of health care facilities. Eventually, this is a course we would like to take outside the Denver Metro area to assist and encourage other local health departments to begin their own training programs.

For more information or questions, please contact Kerri at

—Submitted by Kerri McClory, MSPH
Colorado Department of Public Health and Environment

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