Development of an Active Pulmonary Tuberculosis Patient Screening Process at the Outpatient Department of a General Hospital

Main Article Content

Jetthida Takeaw
Akeau Unahalekhaka
Pimpaporn Klunklin

Abstract

            Effective screening of suspected active pulmonary tuberculosis patients at the outpatient department (OPD) can help prevent tuberculosis transmission in the hospital. The aims of this study were to develop and evaluate the efficiency of a suspected active pulmonary tuberculosis patients screening process at the OPD of a general hospital by using the Appreciation-Influence-Control (AIC) technique. The study was conducted from March to June 2020. The participants included 30 nurses who worked at the OPD, of these, 10 participated in the screening process development and all performed the screening process on patients. The research instruments consisted of an action plan of screening process from the AIC technique, a TB screening form proposed by the Bureau of Tuberculosis, Department of Disease Control at the Ministry of Public Health and the satisfaction questionnaire towards the screening process from Content Validity Index 0.91. Data were analyzed using descriptive statistics and calculation of sensitivity, specificity, positive predictive value and negative predictive value of the screening.
            The results of this study revealed that the screening process consisted of important steps, interviewing to determine the symptoms of the patients, isolating the patients, a fast tract system, and reporting the results of radiology and laboratory investigations to the physician. The developed screening process has the sensitivity and specificity levels of 83.33% and 99.29%, respectively. The positive predictive value and negative predictive value were 14.92% and 99.97%, respectively. Satisfaction with the screening process in terms of convenience of compliance and the benefits obtained were at the highest level. Operational aspects in terms of continuation of performance and suitable duration were at a high level. The developed screening process for active pulmonary tuberculosis patients can be applied for screening suspected active pulmonary tuberculosis patients at the OPD.

Downloads

Download data is not yet available.

Article Details

Section
Research Article

References

World Health Organization. Global tuberculosis report. [Internet]. [cited 2020 January 27]. Available from: https://reliefweb.int/report/world/global-tuberculosis-report-2019.

Bureau of Epidemiology, Department of Disease Control, Ministry of Public Health. Annual epidemiological surveillance report 2011. [Internet]. [cited 2019 February 18]. Available from: http://www.boe.moph.go.th/Annual/AESR2011/index.html. p.72-4. (in Thai).

Netrniym S. Guidelines for the prevention of tuberculosis in public health facilities under the condition of limited resources. Bangkok: Kansans; 2003. (in Thai).

Center for Disease Control and Prevention. Guidelines for preventing the transmission of Mycobacterium tuberculosis in health-care settings, 2005. [Internet]. [cited 2019 February 5]. Available from: http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5417a1.html.

Unahalekhaka A, Lueang-a-papong S, Chitreecheur J. Implementation, obstacles and needs of hospitals in Thailand in preventing tuberculosis transmission. Journal of Health Systems Research 2017;11(4):529-39. (in Thai).

Wattanasiritham P, Srilukwa W. Techniques for building the future. [Internet]. [cited 2019 January 7]. Available from: http://gotoknow.org/blog/paiboon/260442. (in Thai).

Smith WE. Transforming organizations: a five dimensional process. [Internet]. [cited 2019 January 7]. Available from: http://www.odii.com/papers/transforming_organizations.pdf.

Wasi P. Developing the creative power of the organization. 10th ed. Bangkok: Moh-Chao-Ban Publishing House; 2001. (in Thai).

Waraeitipat T, Chitreecheur J, Kasatpibal N. Effects of implementing an action plan based on AIC technique on knowledge and efficiency of pulmonary tuberculosis screening among prison health volunteers. Nursing Journal 2012;39(3):66-76. (in Thai).

Chounchaisit K. Effects of implementing an action plan based on the AIC technique on sterilization practices among personnel and equipment users’ satisfaction. [Master’s Thesis, Faculty of Nursing). Chiang Mai University; 2009. (in Thai).

Konsue W, Chitreecheue J, Yimyam S. Effect of implemeting an action plan based on AIC technique on prevention practices and incidence of needle strick or sharp injuries among nurses. Nursing Journal 2013;40(2):51-63. (in Thai).

Tuberculosis Division, Department of Disease Control, Ministry of Public Health. Screening patients with tuberculosis. [Internet]. [cited 2019 January 7]. Available from: https://www.tbthailand.org. (in Thai).

Tuberculosis Division, Department of Disease Control, Ministry of Public Health. Ending TB in the age of development. [Internet]. [cited 2019 January 7]. Available from: https://www.tbthailand.org. (in Thai).

Prasatthongosoth P. Real life nurses infected with disease from patient care. Hot NEWS [television broadcast]. PPTV; 2017 May 23.

Chobngam S. Development of active pulmonary tuberculosis patients screening in outpatient and emergency department of a university hospital using creative problem solving. [Master’s Thesis, Faculty of Nursing). Chiang Mai University; 2009. (in Thai).

Bureau of Tuberculosis, Department of Disease Control, Ministry of Public Health. National tuberculosis control program guidelines, Thailand 2018. Bangkok: Graphic and Design; 2018. (in Thai).

Bureau of Epidemiology, Department of Disease Control, Ministry of Public Health. Report of disease in the surveillance system for 506 pulmonary tuberculosis. [Internet]. [cited 2019 December 26]. Available from: http://www.boe.moph.go.th/boedb/d506_1/ds_wk2pdf. php?ds=32 &yr=62. (in Thai).

Ingsatit A. Evidence-based medicine on diagnostic study. [Internet]. [cited 2020 August 10]. Available from: http:// www. med.mahidol.ac.th › files › pdf › EBM_Diagnostic_study. (in Thai).

Aupachak S, Picheansathian W, Chitreecheur J. Efficacy of hospital pulmonary tuberculosis screening form. Nursing Journal 2016;43:107-17. (in Thai).

Chounchaisit K, Senaratana W, Yimyam S. Effects of implementing an action plan based on the AIC technique on sterilization among personnel and equipment users’ satisfaction. [Master’s Thesis, Faculty of Nursing). Chiang Mai University; 2009. (in Thai).

Yimyam S. Concept for participatory health development, AIC technique. Chiang Mai: Faculty of Nursing Chiang Mai University of Thailand; 2011. (in Thai).