关键词: 卫生系统机构, 诊断, 专业能力, 数据收集, 研究报告

Abstract:

Objective: To investigate the current situation of tuberculosis laboratories in medical institutions in Gansu Province and provide reference for proposing countermeasures. Methods: One hundred and fifty medical institutions with tuberculosis laboratories in Gansu Province filled out the self-designed online questionnaires by scanning QR codes attached to documents issued by the Health Commission between July 21 and August 10, 2021. The contents of the questionnaire included the basic information of the hospital, the development of the tuberculosis laboratory testing projects, the management of infection control, the configuration of hand hygiene and protective equipment, and the configuration of identification, etc. A total of 150 questionnaires were recovered, of which 146 were valid, with an effective rate of 97.33%. Results: Among the 146 medical institutions, 96 (65.75%) were secondary hospitals, 38 (26.03%) were tertiary hospitals, 12 (8.22%) were ungraded hospitals; 97 (66.44%) general hospitals and 49 (33.56%) specialized hospitals; 146 (100.00%) hospitals carried out acid-fast bacillus smear microscopy, 116 (79.45%) carried out mycobacterium culture, and 99 (67.81%) carried out drug susceptibility testing. The proportion of mycobacterial culture and drug susceptibility testing in specialized hospitals (91.84% (45/49) vs. 87.76% (43/49), respectively) was significantly higher than that in general hospitals (73.20% (71/97) vs. 57.73% (56/97), respectively), the differences were statistically significant (χ²=6.929, P=0.008; χ²=13.443, P<0.001). Weaknesses in laboratory infection control management were that only 80 (54.79%) laboratories had vaccination programmes to prevent infection risk, 5 (3.42%) laboratories could not classify laboratory waste, and 20 (13.70%) laboratories could not deploy biosafety cabinets (17 were secondary medical institutions). Among the 96 secondary hospitals, 13 (13.54%) hospitals did not clearly mark the clean area, buffer zone, contaminated area and did not conduct biological laboratory risk assessment, 11 (11.46%) did not carry out regular training for cleaning staff, 7 (7.22%) out of 97 general medical institutions did not develop the procedures of tuberculosis laboratory access system. In terms of facility and important sign configuration, the allocation rates of goggles, hand-washing charts, operating pathogenic biological agents and biological protection levels were low in ungraded hospitals (83.33% (10/12), 83.33% (10/12), 74.66% (109/146) and 85.62% (125/146), respectively), and 5 (13.16%) of tertiary hospitals no-marked emergency contact information. Conclusion: More specialized hospitals carried out mycobacterium culture and drug sensitivity test than general hospitals in Gansu Province. Management measures related to laboratory infection control and hardware configuration of low-level medical institutions need to be strengthened to ensure safe operation of tuberculosis laboratories.

Key words: Health systems agencies, Diagnosis, Professional competence, Data collection, Research report