Tun-Chieh Chen1, Wei-Ru Lin2, Po-Liang Lu3, Chun-Yu Lin4, Shu-Hui Lin5, Chuen-Ju Lin5, Ming-Chu Feng6, Horn-Che Chiang7, Yen-Hsu Chen8, Ming-Shyan Huang9. 1. Division of Infectious Diseases, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung City, Taiwan; Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung City, Taiwan; Graduate Institute of Medicine, Kaohsiung Medical University, Kaohsiung City, Taiwan. 2. Division of Infectious Diseases, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung City, Taiwan; Department of Infection Control, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung City, Taiwan. 3. Division of Infectious Diseases, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung City, Taiwan; Graduate Institute of Medicine, Kaohsiung Medical University, Kaohsiung City, Taiwan; Faculty of Medicine, Kaohsiung Medical University, Kaohsiung City, Taiwan. 4. Division of Infectious Diseases, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung City, Taiwan; Graduate Institute of Medicine, Kaohsiung Medical University, Kaohsiung City, Taiwan. 5. Department of Infection Control, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung City, Taiwan. 6. Department of Nursing, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung City, Taiwan. 7. Faculty of Medicine, Kaohsiung Medical University, Kaohsiung City, Taiwan; Department of Occupational and Environmental Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung City, Taiwan; National Health Research Institutes, Miaoli County, Taiwan. 8. Division of Infectious Diseases, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung City, Taiwan; Graduate Institute of Medicine, Kaohsiung Medical University, Kaohsiung City, Taiwan; Tropical Medicine Research Center, Kaohsiung Medical University, Kaohsiung City, Taiwan. Electronic address: d810070@cc.kmu.edu.tw. 9. Faculty of Medicine, Kaohsiung Medical University, Kaohsiung City, Taiwan; Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung City, Taiwan.
Abstract
BACKGROUND: We investigated the impacts of introducing an expedited acid-fast bacilli (AFB) smear laboratory procedure and an automatic, real-time laboratory notification system by short message with mobile phones on delays in prompt isolation of patients with pulmonary tuberculosis (TB). METHODS: We analyzed the data for all patients with active pulmonary tuberculosis at a hospital in Kaohsiung, Taiwan, a 1,600-bed medical center, during baseline (January 2004 to February 2005) and intervention (July 2005 to August 2006) phases. RESULTS: A total of 96 and 127 patients with AFB-positive TB was reported during the baseline and intervention phases, respectively. There were significant decreases in health care system delays (ie, laboratory delays: reception of sputum to reporting, P < .001; response delays: reporting to patient isolation, P = .045; and interval from admission to patient isolation, P < .001) during the intervention phase. Significantly fewer nurses were exposed to each patient with active pulmonary TB during the intervention phase (P = .039). CONCLUSION: Implementation of expedited AFB smear laboratory procedures and an automatic, real-time laboratory mobile notification system significantly decreased delays in the diagnosis and isolation of patients with active TB.
BACKGROUND: We investigated the impacts of introducing an expedited acid-fast bacilli (AFB) smear laboratory procedure and an automatic, real-time laboratory notification system by short message with mobile phones on delays in prompt isolation of patients with pulmonary tuberculosis (TB). METHODS: We analyzed the data for all patients with active pulmonary tuberculosis at a hospital in Kaohsiung, Taiwan, a 1,600-bed medical center, during baseline (January 2004 to February 2005) and intervention (July 2005 to August 2006) phases. RESULTS: A total of 96 and 127 patients with AFB-positive TB was reported during the baseline and intervention phases, respectively. There were significant decreases in health care system delays (ie, laboratory delays: reception of sputum to reporting, P < .001; response delays: reporting to patient isolation, P = .045; and interval from admission to patient isolation, P < .001) during the intervention phase. Significantly fewer nurses were exposed to each patient with active pulmonary TB during the intervention phase (P = .039). CONCLUSION: Implementation of expedited AFB smear laboratory procedures and an automatic, real-time laboratory mobile notification system significantly decreased delays in the diagnosis and isolation of patients with active TB.
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