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Vol. 34. Issue 2.
Pages 93-96 (March - April 2019)
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Vol. 34. Issue 2.
Pages 93-96 (March - April 2019)
Short Original
DOI: 10.1016/j.jhqr.2018.11.004
Improving the screening of tuberculosis in patient admitted in a secondary care hospital of La Habana
Mejora de la pesquisa de tuberculosis en pacientes ingresados en un hospital de cuidados secundarios en La Habana
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H. Guanche Garcellb,
Corresponding author
guanche@infomed.sld.cu

Corresponding author.
, A. González Valdésa, L. Gonzalez Alvareza, G. Fresneda Septiema, K. Cardenas Gouleta, V. Hernandez Bravob
a Epidemiology Department, Hospital “Joaquín Albarrán”, Cuba
b Microbiology Department, Hospital “Joaquín Albarrán”, Cuba
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Abstract
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.

Keywords:
Tuberculosis
Sputum-smear positive
Screening
Diagnosis
Hospital
La Habana
Resumen
Introducción

La disminución de los diagnósticos de la tuberculosis en pacientes ingresados en un hospital comunitario en La Habana (Cuba) se identificó como una brecha de calidad y prioridad para la acción. El objetivo: fue aumentar en un 50% el número de baciloscopias y tuberculosis con frotis positivo para diciembre de 2017.

Pacientes y métodos

Una intervención para la mejora de la calidad se realizó desde enero de 2017 hasta diciembre de 2017 en un hospital docente de atención secundaria de 300 camas. El proyecto de mejora se dirigió a pacientes ingresados con infecciones respiratorias (superiores o inferiores). El periodo de base se consideró desde enero a diciembre de 2016. El período de intervención fue de enero de 2017 a junio de 2018. La intervención incluyó actividades de capacitación para el personal médico, monitoreo mensual de baciloscopias realizadas y retroalimentación y análisis con líderes y departamentos.

Resultados

Durante el período basal se confirmaron siete pacientes con tuberculosis pulmonar y se realizaron 160 baciloscopias (media 40 baciloscopias / trimestre). Durante el período de intervención se confirmaron 22 casos de tuberculosis y se realizaron 577 baciloscopias (media 96 baciloscopias / trimestre).

Conclusiones

El número de baciloscopias y la tuberculosis pulmonar se incrementaron en los pacientes ingresados utilizando la educación del personal, el monitoreo y la retroalimentación como medidas de intervención. Los próximos pasos del proyecto se centrarán en lograr la sostenibilidad de la intervención, la evaluación de las necesidades educativas del personal médico y diseñar actividades de capacitación y el cribado de infecciones latentes de tuberculosis mediante la prueba de mantoux en pacientes seleccionados de alto riesgo.

Palabras clave:
Tuberculosis
Frotis positivo
Pesquisa
Diagnostico
Hospital
La Habana

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