"Cough officer screening" improves detection of pulmonary tuberculosis in hospital in-patients

BMC Public Health

Research Article

Shu-Chen Chang¹  Ching-Hsiung Lin²  Woei-Horng Chai²  Cheng-Hung Tsai²  Jen-Ho Wen²  Chun-Eng Liu³  Mei-Li Huang⁴ 

[1] Department of Nursing, Changhua Christian Hospital, 135 Nanshiao Road, Changhua, Taiwan;Division of Chest Medicine, Department of Internal Medicine, Changhua Christian Hospital, 135 Nanshiao Road, Changhua, Taiwan;Division of Infectious Disease, Department of Internal Medicine, Changhua Christian Hospital, 135 Nanshiao Road, Changhua, Taiwan;Infection Control Committee, Changhua Christian Hospital, 135 Nanshiao Road, Changhua, Taiwan;

关键词: Positive Predictive Value;    Negative Predictive Value;    Sputum Smear;    Internal Medicine Department;    Computerize Physician Order Entry System;   

DOI  :  10.1186/1471-2458-10-238

 received in 2009-07-09, accepted in 2010-05-10,  发布年份 2010

来源: Springer

【 摘 要 】

BackgroundCurrent tuberculosis (TB) reporting protocols are insufficient to achieve the goals established by the Stop TB partnership. Some countries have recommended implementation of active case finding program. We assessed the effect of Cough Officer Screening (an active screening system) on the rate of TB detection and health care system delays over the course of four years.MethodsPatients who were hospitalized at the Changhua Christian Hospital (Changhua, Taiwan) were enrolled from September 2004 to July 2006 (Stage I) and August 2006 to August 2008 (Stage II). Stage II was implemented after a Plan-Do-Check-Act (PDCA) cycle analysis indicated that we should exclude ICU and paediatric patients.ResultsIn Stage I, our COS system alerted physicians to 19,836 patients, and 7,998 were examined. 184 of these 7,998 patients (2.3%) had TB. Among these 184 patients, 142 (77.2%) were examined for TB before COS alarming and 42 were diagnosed after COS alarming. In Stage II, a total of 11,323 patients were alerted by the COS system. Among them, 6,221 patients were examined by physicians, and 125 of these patients (2.0%) had TB. Among these 125 patients, 113 (90.4%) were examined for TB before COS alarming and 12 were diagnosed after COS alarming. The median time from COS alarm to clinical action was significantly less (p = 0.041) for Stage I (1 day; range: 0-16 days) than for Stage II (2 days; range: 0-10 days).ConclusionOur COS system improves detection of TB by reducing the delay from infection to diagnosis. Modifications of scope may be needed to improve cost-effectiveness.

【 授权许可】

Unknown   
© Lin et al; licensee BioMed Central Ltd. 2010. This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.