RT Journal Article
SR Electronic
T1 Management of tuberculosis (TB) at a district general hospital: An audit of practice
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP P2831
VO 42
IS Suppl 57
A1 Amiera Awad
A1 Mark Juniper
YR 2013
UL http://erj.ersjournals.com/content/42/Suppl_57/P2831.abstract
AB Background : An initial audit of TB management in 2009 highlighted areas of our service that required improvement. In 2011, a TB Community Nurse Specialist was appointed to address these issues.Objective : To re-assess our management of TB in four key areas: microbiological diagnosis, case reporting to Consultant in Communicable Disease Control, contact tracing and appropriate treatment.Methods : Retrospective analysis of new cases of TB from January 2011 to December 2011. Eligible patients were identified using departmental and micorbiological databases.Results : 30 patients were diagnosed (15 males, 14 females). Mean age was 42 years (range 20-80). There were 19 cases of pulmonary TB, 7 cases of TB lymphadenopathy, 2 pelvic/peritoneal and 2 bone/joint cases of TB. Notification rates improved from 69% to 87% and the number of patients undergoing contact tracing also improved from 69% to 83%. Knowledge of HIV status also improved from 62% to 70%. 77% of patients had a microbiological diagnosis in 2011. This was less than the 100% achieved in 2009. Reasons for this included a patient dying prior to diagnosis and failure to obtain positive culture in a patient who was felt to clinically have TB. 90% of patients were on track to complete treatment and were started on the appropriate regimen.Discussion : Initial results from the 2009 audit are likely to be similar to experiences in TB management in other hospitals. This audit clearly demonstrates the benefits of enlisting a Community Team to help ensure that Physicians are meeting the standards for TB management set out by the British Thoracic Society and National Institute for Clinical Excellence.