Under the direct supervision of the Nurse IV, Director of Nursing/TB Program Manager, performs routine public health work related to directly observed therapy (DOT)/directly observed preventive therapy (DOPT) for the care, treatment, and general welfare of patients diagnosed with Tuberculosis (TB). In accordance with physician’s orders, including through PHR1’s standing delegation orders (SDOs), and public health nurse case manager’s (NCM) direction, observes ingestion of medications, review of potential side effects, documentation, and communicates with case managers regarding stability/acuity of patients with suspected/ active TB disease or latent TB infection. Provides specialized public health services in the home and community. Assesses the client for medication toxicity. Provides individualized care according to policies, procedures, program standards, physician orders, and SDOs, including performing independent home visits to provide and administer TB medications. Provides basic patient/family education to increase knowledge of disease management and prevention. Maintains accountability for medications. Collaborates with the regional public health nurse case manager (NCM). Prepares and maintains appropriate confidential client records per agency standards and HIPAA. Prepares patient summary reports and participates in case reviews to ensure treatment guidelines are met. Carries out QA reviews of patient records throughout PHR 1, assuring adherence to SDOs, timeframes, and treatment protocols to determine compliance with nursing care policies and procedures. Assists in compiling documents required to perform chart audits. Monitors QA and case management activities of other TB team members. Evaluates medical chart data for compliance requirements. Conducts and/or participates in QA reviews within the region and those conducted by the Central Office and, as requested, participate in QA reviews of local health departments or other regions. Completes reports as requested by lead program staff. Abides by Regional SDOs and Texas TB Work Plan. Interprets and follows all laws, requirements, and guidelines regarding the Tuberculosis Program's procedures. Performs other duties as assigned. Works under moderate supervision, with limited latitude for the use of initiative and independent judgment. Works evenings, holidays, and weekends as requested by the TB program as needed. Travel is required; must maintain an acceptable driving record that meets the standards developed by the Texas Department of Public Safety (DPS) and safely operate either a state-owned or personal vehicle to conduct state business in accordance with DSHS Policy OS-3901, Fleet Operations Management and Procedures, and Texas motor vehicle, traffic, and driving licensing law.

Essential Job Functions:
Attends work on a regular and predictable schedule in accordance with agency leave policy and performs other duties as assigned.
Client Services/Case Management (45%)
Observes patients ingest prescribed TB medications, review/observe for potential side effects, and observe and report patients’ stability and/or acuity for patients with suspected/ active TB disease or latent TB infection. Provides specialized public health services in the home and community. Assesses the client for medication toxicity. Provides individualized care according to policies, procedures, program standards, physician orders, and SDOs. Perform independent home visits to patients to provide and administer TB medications. Obtains TB medications and ensures that they are stored safely and securely. Assists with TB case management as directed by public health nurse case manager (NCM). Assists with providing Directly Observed Therapy (DOT) and Video Directly Observed Therapy (VDOT) for identified TB cases in various settings, including client homes and health clinics. Interview clients regarding medication side effects, expressed concerns and observations, and provide accurate, timely reporting of case results to the NCM. May also assist picking up/sending sputum containers and specimen collection and shipping/transport. Locates a client when an appointment is missed with the DOT provider or via the VDOT portal; encourages client cooperation with therapy. Provide patient transportation, if needed.
Documentation/Reports/Quality Assurance (30%)
Documents all services provided using the appropriate forms. Submits completed DOT paperwork and returns timely for review. Prepares and maintains appropriate confidential client records per agency standards and HIPAA. Documents all medications and dosages on the DOT form and enter data in the management system. Communicates with the NCM the status of client's progress, whereabouts, and any client travel plans. Communicate to regional public health nurse case manager (NCM) all findings especially those outside of expected ranges/observations. Prepares patient summary reports and participates in case reviews to ensure treatment guidelines are met. Carries out QA reviews of patient records throughout PHR X, assuring adherence to SDOs, timeframes, and treatment protocols to determine compliance with nursing care policies and procedures. Assists in compiling documents required to perform chart audits. Monitors QA and case management activities of other TB team members. Evaluates medical chart data for compliance requirements. Conducts and/or participates in QA reviews within the region and those conducted by the Central Office and, as requested, participate in QA reviews of local health departments or other regions. Completes reports as requested by lead program staff.
Professional and Patient Education (15%)
Completes DSHS regional training in line with their assigned responsibilities. Required training will be determined by each region. Successfully completes DOT/DOPT observation training with an individual that was trained by the DSHS region before delivering DOT/DOPT services. Attends all required regional trainings and updates under the direction of the region nursing supervisor or Nurse Care Manager (NCM). Abide by all DSHS Standing Delegation Orders, policies and procedures relating to the delivery of DOT/DOPT services and within assigned responsibilities.
Completes at least ICS 100, 200,300, 400, 700 and 800.
Provides basic patient/family education to increase knowledge of disease management and prevention.
Medication/Supply Management (5%)
Maintains accountability for medications. Ensures medical supplies and needed medications are available and current. Identifies and obtains any supplies needed for home/independent visits.
Other Duties as Assigned (5%)
Participates in regional assignments/duties/ and special initiatives. Other duties as assigned include but are not limited to actively participating and/or serving in a supporting role to meet the agency's obligations for disaster response and/or recovery or Continuity of Operations (COOP) activation. Such participation may require an alternate shift pattern assignment and/or location.

Knowledge Skills Abilities:
Knowledge of social, economic, and public health issues; of public health laws and regulations and of medical terminology.
Knowledge of medication administration procedures and principles and processes of used in providing appropriate patient care.
Knowledge of Tuberculosis disease process, treatment management, medications, and identifying side effects and adverse reactions.
Skill in the use of a computer and applicable software.
Skill in medication administration and responding to potential side effects/adverse reaction.
Ability to interpret public health laws and regulations, to analyze and evaluate public health needs, and to communicate effectively.
Ability to provide patient medical care, to prepare and maintain records, to communicate effectively, and to serve as a lead worker providing direction to others.
Ability to provide TB/clinical education to patients and their families professionally, clearly, and compassionately.
Ability to clearly document services provided and follow appropriate processes in completing required forms.
Ability to comprehend program goals, policies, and procedures.
Ability to prioritize time manage multiple caseloads.
Ability to maintain confidentiality.
Ability to travel.

Registration or Licensure Requirements:
Valid and current AHA-approved Healthcare Provider (BLS)Adult, Child, Infant CPR/AED
Current and valid driver’s license

Initial Selection Criteria:
Experience in public health care and health care management (Required)
Experience maintaining confidential records (Required)
Experience in medication administration procedures, reconciliation, and documentation (Required)
Experience in working in a clinical settings (Preferred)
Experience in interpreting and understanding complex policies and procedures (Preferred)
Experience planning, organization and time management (preferred)
Experience solving problems and exercising sound judgment (Preferred)
Experience preparing written reports (Preferred)