Date of Award


Document Type

Independent Study

Degree Name

Master of Science (MS)


The role of the public health nurse in responding to a tuberculosis (TB) outbreak is instrumental in controlling the disease and preventing further spread in a community. This paper focuses on the interventions carried out by public health nurses in Grand Forks, ND where a TB outbreak occurred from 20 IO until 2013 with a peak in cases identified in late 2012. The population affected had unstable housing, low socioeconomic status, and other risk factors for TB. A total of 26 adult and pediatric cases of TB were identified among a closely connected social network with multiple and prolonged exposures to other residents of the community. Public health nurses were responsible for an array of activities from the Public Health Intervention Wheel including: surveillance, health event investigation, outreach, screening, case finding, referral and follow up, case management, delegated functions, health teaching, consultation, collaboration, coalition building, policy development, and social marketing. The public health nurses collaborated with health care providers and area schools to establish a TB task force. The task force served as a conduit of information to the public through the media. TB skin testing and health teaching were provided at three schools, multiple worksites, a regional correctional facility, and at the local health department. A total of 1,800 individuals received TB tests and consequently, 70 individuals were placed on preventive therapy for latent TB infection. Social determinants of health such as poverty, unstable housing, unemployment, and incarceration were impediments to successful treatment; however, the public health nurses remained committed to the goal of I 00% completion of treatment for all clients with TB. Following in the footsteps of early public health nursing leaders from more than I 00 years ago, they created partnerships, mobilized the community, and applied interventions from the Public Health Intervention Wheel at individual, community and systems levels to address the threat of an age old communicable disease - TB.