title: Implementation of tuberculosis infection control measures in designated hospitals in Zhejiang Province, China: are we doing enough to prevent nosocomial tuberculosis infections?
abstract: OBJECTIVE
  Tuberculosis (TB) infection control measures are very important to prevent nosocomial transmission and protect healthcare workers (HCWs) in hospitals. The TB infection control situation in TB treatment institutions in southeastern China has not been studied previously. Therefore, the aim of this study was to investigate the implementation of TB infection control measures in TB-designated hospitals in Zhejiang Province, China.
  
  
  METHODS
  Cross-sectional survey using observation and interviews.
  
  
  METHODS
  All TB-designated hospitals (n=88) in Zhejiang Province, China in 2014.
  
  
  METHODS
  Managerial, administrative, environmental and personal infection control measures were assessed using descriptive analyses and univariate logistic regression analysis.
  
  
  RESULTS
  The TB-designated hospitals treated a median of 3030 outpatients (IQR 764-7094) and 279 patients with confirmed TB (IQR 154-459) annually, and 160 patients with TB (IQR 79-426) were hospitalised in the TB wards. Most infection control measures were performed by the TB-designated hospitals. Measures including regular monitoring of TB infection control in high-risk areas (49%), shortening the wait times (42%), and providing a separate waiting area for patients with suspected TB (46%) were sometimes neglected. N95 respirators were available in 85 (97%) hospitals, although only 44 (50%) hospitals checked that they fit. Hospitals with more TB staff and higher admission rates of patients with TB were more likely to set a dedicated sputum collection area and to conduct annual respirator fit testing.
  
  
  CONCLUSIONS
  TB infection control measures were generally implemented by the TB-designated hospitals. Measures including separation of suspected patients, regular monitoring of infection control practices, and regular fit testing of respirators should be strengthened. Infection measures for sputum collection and respirator fit testing should be improved in hospitals with lower admission rates of patients with TB.
authors.affiliation: Department of Tuberculosis Control and Prevention, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, Zhejiang, China.
authors.forename: Bin
authors.initials: B
authors.lastname: Chen
authors.affiliation: School of Nursing, Wenzhou Medical University, Wenzhou, Zhejiang, China.
authors.forename: Min
authors.initials: M
authors.lastname: Liu
authors.affiliation: Department of Science Research and Information Management, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, Zhejiang, China.
authors.forename: Hua
authors.initials: H
authors.lastname: Gu
authors.affiliation: Department of Tuberculosis Control and Prevention, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, Zhejiang, China.
authors.forename: Xiaomeng
authors.initials: X
authors.lastname: Wang
authors.affiliation: Auditory Research Laboratory, State University of New York, Plattsburgh, New York, USA.
authors.forename: Wei
authors.initials: W
authors.lastname: Qiu
authors.affiliation: School of Nursing, Wenzhou Medical University, Wenzhou, Zhejiang, China Department of Geriatrics, Zhejiang Provincial People's Hospital, Hangzhou, Zhejiang, China Department of Nursing, Zhejiang Medical College, Hangzhou, Zhejiang, China.
authors.forename: Jian
authors.initials: J
authors.lastname: Shen
authors.affiliation: Department of Science Research and Information Management, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, Zhejiang, China School of Laboratory Medicine, Wenzhou Medical University, Wenzhou, Zhejiang, China.
authors.forename: Jianmin
authors.initials: J
authors.lastname: Jiang
mesh_terms: D002681:China; D003428:Cross Infection / Q000517:prevention & control*; D003430:Cross-Sectional Studies; D006761:Hospitals / Q000706:statistics & numerical data*; D006801:Humans; D017053:Infection Control / Q000379:methods*; D017758:Infectious Disease Transmission, Patient-to-Professional / Q000517:prevention & control*; D007902:Length of Stay; D016015:Logistic Models; D014376:Tuberculosis / Q000517:prevention & control*