(444 institutions) of hospitals with 100 beds or more that were listed in the American Hospital Association database (Manangan et al., 1998). The response rate was about 70 percent for each group (726 institutions total). (Note that Table 6-1, described in the next paragraph, covers only a subset of this survey’s respondents.) Half of the respondents reported that their institutions had admitted six or more patients with tuberculosis. One-quarter said that their institutions had admitted patients with multidrug-resistant disease. Nearly all reported some kind of tuberculin skin testing program. Just over 70 percent reported having isolation rooms that met the 1990 CDC criteria for the isolation of patients with tuberculosis, but 60 percent of that group reported that their institutions did not routinely check the airflow in isolation rooms. Of those that did routinely check, few (13 percent) checked it at least monthly. One of five institutions allowed patients out of isolation for other than medical reasons. Although nearly 90 percent reported that their policy was to keep

TABLE 6-1. Comparison of Tuberculosis Control Measures for 103 Hospitals That Reported More than Six Admissions of Patients with Tuberculosis in 1992 CDC Survey and That Also Responded to 1996 CDC Survey

 

1992 No. (%)

1996 No. (%)

Engineering Controls

Isolation rooms meeting CDC criteria

59/92 (64)

99/103 (96)

Routine check of negative air pressure

42/85 (49)

96/99 (97)

Monthly check of negative air pressurea

5/35 (14)

76/90 (84)

Respiratory Protectionb

Nonfitted surgical mask

69/101 (68)

1/103 (1)

Soft mask, molded or fitted

34/101 (34)

NA

Particulate respirator

8/101 (8)

40/103 (39)

N95

NA

85/103 (83)

Tuberculin Skin Testing Program

Testing by Worker Category

Nurses

103/103 (100)

103/103 (100)

Respiratory therapists

102/103 (99)

103/103 (100)

House staff

65/81 (69)

65/73 (89)

Attending physicians

43/86 (50)

65/94 (69)

Students

55/95 (58)

74/97 (76)

Testing Elements

After exposure incident

98/101 (97)

102/103 (99)

Two-step testing

NA

77/98 (79)

Maintain yearly reports

64/98 (65)

93/98 (95)

aWhen an isolation room is actually in use for a patient with suspected or confirmed tuberculosis, the 1994 CDC guidelines recommend that pressure be checked daily.

bNumbers add to more than one hundred because facilities may use more than one type of mask.

SOURCE: Manangan et al., 1998.



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