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Tuberculosis Isolation: Comparison of Written Procedures and Actual Practices in Three California Hospitals
Formats Available in JSTOR: PDF
Abstract(back to top)
OBJECTIVE. To evaluate implementation of healthcare worker exposure control measures for tuberculosis (TB)‐patient isolation, as specified by Centers for Disease Control and Prevention (CDC) guidelines and the hospital’s TB‐control policy.
DESIGN. Prospective multihospital study comparing CDC guidelines and hospital policy for TB‐patient isolation to onceweekly observations of TB‐patient isolation practices over 14 consecutive weeks at each hospital.
SETTING. Three urban hospitals (two county, one private community) in counties in California with a high incidence rate of TB.
MEASUREMENTS. Work practices for TB‐patient isolation were observed and ventilation performance of isolation rooms was assessed while patient rooms were in use for TB isolation.
RESULTS. Of 170 TB‐patient rooms observed, 119 (70%) involved a patient in a designated TB isolation room, the room was under negative pressure, the door was closed, and a “respiratory precautions” sign was on the door; 32 patient‐room units (19%) were not under negative pressure or not designated as negativepressure rooms. Of 151 patient‐room units mechanically capable of negative pressure at a prior point in time, 16 (11%) were not under negative pressure at the time of use. Of 67 patient‐room units equipped with continuous monitoring devices, 8 (12%) involved devices that did not accurately reflect the direction of airflow. Of the 62 healthcare workers observed using a respirator for TB, 40 (65%) did not don the respirator properly.
CONCLUSIONS. Implementing CDC guidelines for TBpatient isolation was feasible but imperfect in the three hospitals. Day‐to‐day work practices deviated from hospital policy. Prospectively quantifying the implementation of a hospital TB isolation policy while the room is in use may lead to improved estimates of risk and may help to identify and thereby prevent avoidable healthcare worker exposures to Mycobacterium tuberculosis aerosol. Auditing practices and verifying equipment performance is likely to identify unexpected problems in implementation of the TB control program.
Bibliographic Information(back to top)
- Tuberculosis Isolation: Comparison of Written Procedures and Actual Practices in Three California Hospitals
- Patrice M. Sutton , MPH, Mark Nicas , PhD, MPH and Robert J. Harrison , MD, MPH
- Infection Control and Hospital Epidemiology
- Vol. 21, No. 1 (January 2000) (pp. 28-32)
Notes and References(back to top)
This item contains 1 note(s).
Notes
From the Public Health Institute (Ms. Sutton); the Center for Occupational and Environmental Health (Dr. Nicas), School of Public Health, University of California; the California Department of Health Services (Dr. Harrison), Berkeley, California.Address reprint requests to Patrice M. Sutton, MPH, Public Health Institute, California Department of Health Services, 1515 Clay St, Suite 1901, Oakland, CA 94612.This project was supported by a cooperative agreement (#U50/CCU910074) between the National Institute for Occupational Safety and Health (NIOSH) and the California Department of Health Services in collaboration with the Public Health Institute. The authors thank Teri Palermo, RN, and John E. Parker, MD, of the Division of Respiratory Disease Studies at NIOSH for their consistent and helpful support of this study. The active participation of infection control, environmental health, nursing, and other hospital staff in the design and implementation of this study was invaluable to the successful completion of this research.98‐OA‐178. Sutton PM, Nicas M, Harrison RJ. Tuberculosis isolation: comparison of written procedures and actual practices in three California hospitals. Infect Control Hosp Epidemiol 2000;21:28‐32.
Items Citing this Item (back to top)
1 item(s) in JSTOR cite this item
- M. C. Lee , MD; S. Takaya , MD; R. Long , MD; A. M. Joffe , MDVol. 29, No. 12 (December 2008) pp. 1149-1156Stable URL: http://www.jstor.org/stable/10.1086/591860