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Collaboration With School Nurses
Improving the Effectiveness of Tuberculosis Screening
Cynthia W. DeLago, MD;
Nancy D. Spector, MD;
Beth Moughan, MD;
Mary M. Moran, MD;
Hans Kersten, MD;
Laura Smals, MD
Arch Pediatr Adolesc Med. 2001;155:1369-1373.
Objective To compare tuberculosis skin test (TST) reading rates between children
whose tests were read by school nurses following specific requests by physicians
and those who relied on their parents to get their tests read, either at school
or at the physician's office.
Design A randomized controlled trial.
Setting An urban hospital-based pediatric practice.
Participants Healthy low-income Hispanic and African American children aged 5 to
17 years whose physicians ordered TSTs at their routine physical examinations.
Subjects attended 1 of 68 public schools. Nurses at these schools were willing
to read student TSTs, and received instructions about how to read and report
the results back to the physician's office.
Intervention Subjects were randomized to a control group (routine TST placement,
with no physician–to–school nurse communication) or to an intervention
group (routine TST placement, with physician–to–school nurse communication).
Main Outcome Measures Tuberculosis skin test reading rates between the 2 groups were compared.
Impediments to TST reading and reporting were investigated.
Results One hundred thirty-four children were enrolled, 54 (40%) in the control
group and 80 (60%) in the intervention group. More patients in the intervention
group had their TSTs read by 72 hours compared with those in the control group
(74 [92%] vs 30 [56%]; P<.001). The low reading
rate in the control group was best attributed to communication failures.
Conclusion Systematic collaboration with school nurses can increase TST reading
rates.
From the Section of General Pediatrics, St Christopher's Hospital for
Children and MCP Hahnemann University School of Medicine, Philadelphia, Pa.
Corresponding author and reprints: Cynthia W. DeLago, MD, Section
of General Pediatrics, St Christopher's Hospital for Children and MCP Hahnemann
University School of Medicine, Erie Avenue at Front Street, Philadelphia,
PA 19134-1095 (e-mail: Cynthia.W.DeLago{at}drexel.edu).
THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES
OTHER ARTICLES NOTED (Nov 01 to 18 Oct 02)
Evid. Based Nurs. 2003;6:e1-1.
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