Online Program

Evaluation of Latent Tuberculosis Infection Screening in the Field Setting

Tuesday, November 3, 2015 : 11:30 a.m. - 11:45 a.m.

Gema Morales-Meyer, DNP, RN, CRRN, CNS, APHN-BC, Community Health Services, Los Angeles County Department of Public Health, Los Angeles, CA
Penny Weismuller, DrPH, RN, School of Nursing, California State University, Fullerton, Fullerton, CA
Background: The Tuberculin Skin Test (TST), developed in the early 1900s, has been the primary test for Tuberculosis (TB) screening in the Los Angeles County Public Health Department (LACDPH).  In 2006, a new test for TB screening, Interferon Gamma Release Assays (IGRA), was developed.  Research evidence demonstrates that IGRA testing has improved sensitivity and specificity over TST results and thus, reports fewer false positive results stemming from BCG vaccination or non-tuberculosis mycobacterial infections. 

Issue: In 2013, the department began the implementation of IGRA in the clinic and field setting as evidence based practice for public health nursing. This presentation will report the evaluation of this implementation of IGRA including: (a) usage of IGRA in the field, (b) comparison of latent TB infection rates in 2013 and 2014, and (c) cost analysis of screening with TST and IGRA.

Lessons Learned and Implications: The evaluation showed that adoption of evidence based practices can vary in different settings and barriers need to be identified and addressed in order to ensure implementation that benefits patient outcomes. TB infection rates decreased after IGRA implementation, likely due to IGRA’s increased sensitivity and specificity.  The change to IGRA testing was cost effective due to a decrease in LTBI treatment as fewer TB false positive tests occurred.  Implications for all local public health departments include the feasibility of IGRA testing in the public health field setting and the improvement in identification of true TB infections.

Learning Areas:

Administration, management, leadership
Conduct evaluation related to programs, research, and other areas of practice
Public health administration or related administration
Public health or related nursing

Learning Objectives:
Describe cost effective improvements for Tuberculosis screening in the field setting. Identify barriers in the adoption of evidence based practice and strategies to address them

Keyword(s): Evidence-Based Practice, Tuberculosis

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have worked on this project as part of my DNP course work and my role within the public health department.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

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