1. EXCELLENCE  EXPERTISE  INNOVATION Core Nursing Values The TB Binational Project Catalina Navarro RN, BSN Heartland National TB Center February 23, 2012

2. EXCELLENCE  EXPERTISE  INNOVATION US-Mexico Border

3. EXCELLENCE  EXPERTISE  INNOVATION Tuberculosis Rates U.S. – Mexico Border States, 2008 The four U.S. border states have the highest per population infection rate in the U.S. The six Mexican border states have TB incidence rates among the highest in Mexico Source: CDC, 2008; CDPH, 2008; DGEPI Mexico, 2008; INEGI, 2005; SINAVE, 2007. *Based on 2007 data. **All United States data is based on all types of TB and all Mexico data is based on pulmonary TB only.

4. EXCELLENCE  EXPERTISE  INNOVATION Challenges to Treat TB in the Border High poverty rates Overcrowding living conditions Limited access to health services Non adherence to treatment Personnel shortages in HC system Lack of coordinated care Limited access to food Violence

5. EXCELLENCE  EXPERTISE  INNOVATION How to Overcome the Challenges?

6. EXCELLENCE  EXPERTISE  INNOVATION

7. US-Mexico Binational Projects

8. EXCELLENCE  EXPERTISE  INNOVATION Texas-Mexico Projects Sin Fronteras Los Dos Laredos Juntos Esperanza y Amistad

9. EXCELLENCE  EXPERTISE  INNOVATION Los Dos Laredos Binational Project Activities Provide expert consultation on complicated cases (specially MDR). Pt were seen and evaluated in Mexico by US staff Nurse case management (NCM) exhibiting Core Values along the border

10. EXCELLENCE  EXPERTISE  INNOVATION Nurse Case Management (NCM) Along the Border

11. EXCELLENCE  EXPERTISE  INNOVATION Nurse Case Management and Core Values Excellence Integrity Accountability Respect Diversity

12. EXCELLENCE  EXPERTISE  INNOVATION Conclusions Binational Nurses in collaboration with US nurses: Are dedicated to serving the people of the US-Mexico border taking in consideration their unique and diverse needs Are committed to control the TB in the US-Mexico border working with high standards based on the values of Integrity, excellence, diversity, respect, and accountability Applied all the elements of Nurse Case Management NCM in the treatment of TB Undertake many roles in the management of patient with TB

13. EXCELLENCE  EXPERTISE  INNOVATION References Pan American Health Organization/World Health Organization. The Situation of Tuberculosis on the United States- Mexico Border El Paso, TX: PAHO/WHO. March 2011 CDC. Preventing and Controlling Tuberculosis Along the U.S.-Mexico Border. Work Group Report. MMWR January 19, 2001/Vol.50/No. RR-1

14. EXCELLENCE  EXPERTISE  INNOVATION