Tuberculosis (TB) is a significant concern in congregate settings, including correctional facilities and detention centers. Residents in correctional facilities are at a higher risk than the general population of becoming infected with TB. Correctional nurses must follow organizational protocols and national guidelines for TB screening to ensure the safety of detainees, corrections staff, and the community. The utilization of purified protein derivative (PPD) skin test has been established as the standard practice for rapidly detecting TB due to its simplicity and cost-effectiveness. A quality improvement project was designed and implemented at two correctional facilities in Georgia to address a recognized lapse in TB screening adherence. The intervention included an educational component with a TB screening knowledge pretest and posttest for nurses employed at these correctional facilities. Summative TB screening data were also analyzed for the two months pre- and post-intervention to determine protocol adherence by the nursing staff and to measure the impact of the training on the change in screening rates and methods. After the educational intervention, participants scored 7.3% higher on the posttest than the pretest. Post-intervention summative data indicated an increase of greater than 10% in areas of TB screenings completed upon admission to the facility and the proportion of screenings completed with PPD. Significant decreases were also seen in the areas of missed TB screenings and chest radiographs ordered solely due to BCG vaccination status. While this indicated a successful intervention and achievement of most project outcomes, the area of chest radiographs ordered outside of protocol parameters experienced a negative response—more chest radiographs were ordered outside of protocol than prior to intervention. This could represent an increased awareness of the need to complete TB screenings without adhering to the screening guidelines. Another plan-do-study-act cycle is recommended to address the continued issue of chest radiographs for TB screening ordered outside the protocol parameters.
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- Alternative title
Tuberculosis Education for Correctional Nurses
- Thesis grantor
Doctor of Nursing Practice
- Date submitted
2 May 2023
- Qualification level