On Nurses' Understanding of Tuberculin Testing: the Importance of Training
Conocimiento de la prueba de la tuberculina entre el personal de enfermería. Importancia de la formación.
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"etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "affa" ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Conocimiento de la prueba de la tuberculina entre el personal de enfermería. Importancia de la formación." ] ] "textoCompleto" => "<p class="elsevierStylePara"><span class="elsevierStyleBold"> To the editor:</span> We have read with interest the excellent article by Alemany et al, "Assessment of Nurses' Understanding of Tuberculin Testing at a General Hospital"<span class="elsevierStyleSup">1</span> and are sending this letter in the belief that the results of a recent study we have made may complement the authors' conclusions. In spite of the fact that tuberculin testing was introduced almost a century ago by Charles Mantoux and regulated by the World Health Organization in the 1960s,<span class="elsevierStyleSup">2</span> the level of theoretical knowledge of the technique among the nurses in this study<span class="elsevierStyleSup">1</span> as well as in other recent studies,<span class="elsevierStyleSup">2</span> and observed in our own experience, is totally unacceptable and an insufficient guarantee of the correct implementation and interpretation of this technique.</p><p class="elsevierStylePara">We agree with Alemany et al<span class="elsevierStyleSup">1</span> that nurses who have received special training in carrying out this test should be selected if we want to reduce the possibilities of errors made during its administration. However, this is not always possible. One aspect that has not been analyzed by these authors is the effect of previous specific training in this field. In our study, which was presented in detail at the last National Congress of the Spanish Society of Pulmonology and Thoracic Surgery (SEPAR),<span class="elsevierStyleSup">3</span> a questionnaire containing 10 questions on how to preserve, implement and read the results of the tuberculin test was administered. It was based on the recommendations of the International Union against Tuberculosis and Lung Disease<span class="elsevierStyleSup">4</span> and of SEPAR.<span class="elsevierStyleSup">5</span> Other variables such as professional experience, training, and practice in using this technique were recorded. Out of the 202 nurses who completed the questionnaire, 49 (24.2%) had received some form of specific training and the mean number of correct responses was significantly higher for this group (6.7±2 as opposed to 5±1.5; <span class="elsevierStyleItalic">P</span>=.001). Multivariate analysis showed that, in addition to the frequency with which nurses carried out the test, having participated in some form of previous training was an independent factor strongly associated with greater theoretical knowledge. In the study made by Córcoles et al,<span class="elsevierStyleSup">2</span> which was carried out in 100 national health centers, nurses who had taken a course within the previous 3 years had a 40% higher probability of having a high level of understanding of the technique.</p><p class="elsevierStylePara"> Although the use of specially qualified staff to carry out this test is probably the best way of reducing the risk of errors, when this is not possible the regular staff's attendance at courses and seminars on the technique could reduce the risk.</p><p class="elsevierStylePara">As pulmonologists, we feel that we should participate actively in such training activities and it would be worthwhile for SEPAR to sponsor the creation of graphic and audiovisual material on tuberculin testing and its distribution among nursing staff to complement the recommendations already published,<span class="elsevierStyleSup">3</span> or even to make a summary of this information available on the SEPAR web page, as has been done for other disciplines.<span class="elsevierStyleSup">6</span></p>" "pdfFichero" => "260v39n11a13053348pdf001.pdf" "tienePdf" => true "bibliografia" => array:2 [ "titulo" => "Bibliography" "seccion" => array:1 [ 0 => array:1 [ "bibliografiaReferencia" => array:6 [ 0 => array:3 [ "identificador" => "bib1" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:3 [ "titulo" => "Valoración del conocimiento de la prueba de la tuberculina entre el personal de enfermería de un hospital general." 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"idioma" => "es" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:7 [ 0 => "Córcoles MP" 1 => "Moreno T" 2 => "Comet P" 3 => "Orts MI" 4 => "Gómez I" 5 => "Martínez MA" 6 => "et al." ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Enfermería Clínica" "fecha" => "2002" "volumen" => "12" "paginaInicial" => "135" "paginaFinal" => "42" ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib3" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "referenciaCompleta" => "Conocimiento de los profesionales de enfermería sobre la prueba de la tuberculina. Arch Bronconeumol 2003,39(Supl 2):130." "contribucion" => array:1 [ 0 => array:3 [ "titulo" => "Conocimiento de los profesionales de enfermería sobre la prueba de la tuberculina. Arch Bronconeumol 2003,39(Supl 2):130." "idioma" => "es" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "Fernández-Villar A" 1 => "Muñoz MJ" 2 => "Leiro V" 3 => "Núñez M" 4 => "Mosteiro M" 5 => "Piñeiro L." ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib4" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "referenciaCompleta" => "Guidelines for conducting tuberculin skin test surveys in high prevalence countries. Tubercle Lung Dis 1996:77 (Suppl):1-20." "contribucion" => array:1 [ 0 => array:3 [ "titulo" => "Guidelines for conducting tuberculin skin test surveys in high prevalence countries. Tubercle Lung Dis 1996:77 (Suppl):1-20." "idioma" => "en" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "Arnadottir T" 1 => "Rieder HL" 2 => "Trebucq A" 3 => "Waaler HT." ] ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib5" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "referenciaCompleta" => "Recomendaciones SEPAR. Diagnóstico de la tuberculosis. Arch Bronconeumol1996;32:85-99." "contribucion" => array:1 [ 0 => array:3 [ "titulo" => "Recomendaciones SEPAR. Diagnóstico de la tuberculosis. Arch Bronconeumol1996;32:85-99." "idioma" => "es" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "Caminero JA" 1 => "Casal M" 2 => "Auxina V" 3 => "Pina JM" 4 => "Sauret J." ] ] ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib6" "etiqueta" => "6" "referencia" => array:1 [ 0 => array:2 [ "referenciaCompleta" => "Área de trabajo de Enfermería y Fisioterapia de la SEPAR [consultado 4/4/2003]. Disponible en: http://www.separ.es/areas/enfermeria. htm." "contribucion" => array:1 [ 0 => array:3 [ "titulo" => "Área de trabajo de Enfermería y Fisioterapia de la SEPAR [consultado 4/4/2003]. Disponible en: http://www.separ.es/areas/enfermeria. htm." 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