Improving the screening of tuberculosis in patient admitted in a secondary care hospital of La Habana.

INTRODUCTION

The reduction of tuberculosis reported in admitted patients in a community hospital in La Habana (Cuba) was identified as a quality gap and priority for action. The objective was to increase by 50% the number of bacilloscopies and smear-positive tuberculosis confirmed by December 2017.

PATIENTS AND

METHODS

A quality improvement initiative was conducted from January 2017 to December 2017 in a 300-bed secondary care teaching hospital. The improvement project was addressed to patients admitted with respiratory infections (upper or lower). The baseline was considered the period from January to December 2016. The intervention period was from January 2017 to June 2018. The intervention includes training activities for medical staff, monthly monitoring of bacilloscopies performed and feedback and analysis with leaders and departments.

RESULTS

During the baseline period seven patients were confirmed with pulmonary tuberculosis and 160 bacilloscopies were performed (mean 40 bacilloscopies/quarter). During the intervention period were confirmed 22 cases of tuberculosis and 577 bacilloscopies were performed (mean 96 bacilloscopies/quarter).

CONCLUSIONS

The number of bacilloscopies and sputum smear tuberculosis was successfully increased in admitted patients using the staff education, monitoring, and feedback as intervention measures. The next steps of the project will be focused in achieve the sustainability of the intervention, evaluation of educational needs of medical staff and design training activities accordingly and, screening of latent tuberculosis infections using of tuberculin skin test in selected high risk admitted patients.