Tuberculosis (TB) Screening among Healthcare Workers (HCW) in Hospital and Long-Term Care Facilities: A Quality Improvement Project to Assess and Improve HCW’s Perspective and Willingness in Implementing Guidelines for TB Screening
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Tuberculosis (TB) Screening among Healthcare Workers (HCW) in Hospital and Long-Term Care Facilities: A Quality Improvement Project to Assess and Improve HCW’s Perspective and Willingness in Implementing Guidelines for TB Screening

Abstract

Tuberculosis (TB) was considered one of the ten leading causes of death worldwide among all genders due to the failure of early detection or initiation of treatment. It was established that TB was a preventable and curable disease after years of documented research and implementation of disease management programs that address the disease process. However, it still results in a high mortality rate by killing more people than any other infection.The purpose of this project was to assess the willingness of stakeholders to implement the CDC’s 2019 TB screening guidelines among healthcare workers through the identification of barriers and facilitators of effective implementation and use these to educate providers, managers, or policymakers to see if it would increase their willingness to adhere to the recommended TB screening and testing guidelines in their facility. Gaps in implementing healthcare guidelines are evidenced by two domains: healthcare worker and facility/ management related. The study utilized the Consolidated Framework for Implementation Research (CFIR) to encourage hospital and long-term care facility stakeholders to willingly implement the current TB screening guideline once made available. A total of 21 participants completed the survey; they were stakeholders who are knowledgeable of the infection control practices within their facility. I provided education on the updated TB screening guideline for HCWs, shared the evidence-based implementation of healthcare protocols, and shared best practices identified from other hospitals and long-term care facilities. I also employed educational presentations utilizing the CDC's slide sets for HCWs screening and testing, highlighting the significant changes between the 2005 and 2019 TB screening guidelines and evidence-based recommendations to implement the newest TB screening guidelines for HCWs. Overall, results showed that most participants thought that the 2019 TB screening guideline was feasible to implement within their facilities. After the implementation, 86% of the participants were willing to implement the guideline once made available, wherein 14% were unsure due to perceived risks to the high elderly population and their proximity to the border. The participants also acknowledged that support and communication are the main barriers to successfully implementing the TB screening guideline. The participants thought that they felt equipped to provide effective and efficient guidance in implementing the TB screening guidelines among HCWs within their facilities with the resources provided. Lastly, I can conclude that the project was successful by showcasing a significant increase in knowledge, attitude, behavior, and high willingness of HCWs to implement the 2019 TB screening guideline within their facilities after the intervention.

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