Development of Nursing Management Models to Prevent and Control the Spread of Tuberculosis Infection, Maha Sarakham Hospital

Abstract

Background and Objectives The transmission of pulmonary tuberculosis (TB) in hospitals remains a significant problem. Although the Ministry of Public Health has issued guidelines, their implementation within individual units has been unclear, varies according to the skills and experience of nurses, and lacks consistency. Healthcare worker infections continue to be reported. This study aimed to develop and evaluate a nursing management model to prevent and control the transmission of pulmonary tuberculosis at Maha Sarakham Hospital.

Research Methodology This action research consisted of three phases: a situational analysis phase, a development phase, and an evaluation phase. Participants were divided into two groups: 80 registered nurses and 142 newly diagnosed pulmonary TB patients. Research instruments included focus group interview guides (IOC = 0.89), medical record and TB patient screening data recording forms (IOC = 0.87), a nursing management assessment tool (CVI = 0.87, KR-20 = 0.86), and a satisfaction assessment tool (CVI = 0.85, Cronbach's alpha = 0.92). Data were analyzed using descriptive statistics.

Research Findings Phase 1 revealed that only 38.75% of registered nurses practiced according to the guidelines appropriately and comprehensively, and TB patient screening using standardized questions was conducted in only 44.75 % of cases. Phase 2 — following development through three action research cycles — produced the ALERT-TB Model, comprising: A – Active screening at the front line to identify pulmonary TB patients, L – isolation of patients/suspected TB cases in isolation rooms or negative pressure rooms within each ward, and transfer to a dedicated TB unit, E – Environmental arrangement to prevent transmission, R – use of personal protection measures, emphasizing personal protective equipment (PPE), T – surveillance among medical and nursing personnel, T – discharge planning and patient/family education, B – supervision and monitoring of practice. Phase 3 — following implementation — found that 86.25% of registered nurses were able to follow the guidelines appropriately and comprehensively at a very good level, and satisfaction with the model was rated at the highest level.

Conclusion and Recommendations The developed ALERT-TB Model can be effectively used as a practice standard for registered nurses in preventing and controlling pulmonary tuberculosis transmission in hospitals. It is further recommended that artificial intelligence technology be incorporated to support ongoing screening efforts.