Improving tuberculosis infection control in the Mossel Bay sub-district of the Western Cape : a quality improvement project
Thesis (MFamMed)--Stellenbosch University, 2018.
ENGLISH SUMMARY : Introduction: Tuberculosis (TB) is a major global health challenge, and South Africa is one of the high-burden countries. A national TB infection control (TBIC) guideline has stipulated three main areas of infection control at health facilities: work practice and administrative control; environmental control; and personal protection for health workers. The purpose of this project was to identify the gaps and address the challenges in TB infection control in the Mossel Bay sub-district in the Western Cape. Methods: A quality improvement cycle was used to evaluate and improve TBIC according to the national TBIC draft guideline. Two facilities within the sub-district were used, the district hospital and a primary health care clinic. Each had an existing infection and prevention control and occupational health and safety team, which were used as the audit teams. Results: A baseline assessment was followed by a set of interventions, which failed to show a significant improvement in TBIC. The difference between the pre- and post-intervention TB screening rate was not statistically significant. An assessment of time interval between 101 patients presenting with TB symptoms and diagnosed with TB was four days at baseline and post-intervention. Most of the anticipated improvements were dependent on the health workers’ adherence to the local TBIC policies, which emerged as an unexpected finding. Conclusion: The study found good managerial commitment reflected by the presence of various policies, guidelines, specific personnel and committees to deal with infection control in general. The project has created awareness about tuberculosis infection control among the staff. It also pointed out the complexity of health workers’ behaviour towards adhering to policies.
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