The healthcare profession presents practitioners with a number of hazards. Unless they take action to shelter themselves against the hazards, the practitioners may suffer harm. One of these hazards involves contracting an illness from a patient. While most medical institutions take precautions to protect their practitioners, there are instances where the practitioners contract illnesses from their patients. Disregarding safety protocols and the absence of safe operating environments are among the factors that encourage the transmission of illnesses from the patient to the practitioner. Practitioners are more likely to contract illnesses that are contagious. Tuberculosis (TB) is one of the most infectious illnesses. Thousands of practitioners such as nurses and physicians have contracted this illness from their patients. Tuberculosis is indeed a serious illness that afflicts millions of people around the world. According to the World Health Organization, there were over 10 million cases of the disease (WHO, 2018). 1.7 million of those who contracted the infection died. What makes TB is a serious health challenge is the fact that there are some strains that are resistant to treatment. Patients who fail to seek treatment compound the challenges of the medical profession as it seeks to tackle this disease. There are various symptoms which characterize this infection. They include fatigue, fever, malaise, excessive sweating at night and chronic cough, among others (Raviglione, 2016).
The fact that these practitioners do not know that their patients have the infection has been blamed for the transmission. The need to investigate the link between the exposure to TB and the lack of knowledge regarding the patient’s ailment cannot be overstated. With an understanding of this link, practitioners can institute protective measures. For example, greater resources and effort can be committed to diagnosis. Quick and accurate diagnosis enables the practitioners to determine the illness that is ailing the patient. The patient can then be isolated to minimize the risk of infecting the practitioners and other patients. It is also important to determine the association between knowledge of the patient’s ailment and exposure to TB so as to safeguard the wellbeing of practitioners. It is nearly impossible for the practitioners to execute their mandate when they are sick. Moreover, investigating how lack of knowledge regarding the patient’s health and exposure to TB facilitates the establishment of safety protocols. Overall, the study is vital as it offers insights into the measures that medical institutions can institute to protect practitioners and patients. There is an association between the lack of knowledge that a patient has TB and the exposure of healthcare workers to this illness. This study tests the hypothesis that lack of knowledge that patients have TB is among the factors that expose health workers to this illness. For the study, the exposure to TB is the dependent variable while the lack of knowledge concerning the TB status of patients is the independent variable.
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Problem Statement
Lack of sufficient knowledge among health care workers has led to increase exposure to TB risk. In the event that the health care workers have awareness about a patient’s infection, this would probably reduce the likelihood of them becoming victims of the disease.
Literature Review
The health hazards that practitioners encounter in the performance of their duties have been the subject of years of scholarly research. For example, during the Ebola crisis, dozens of healthcare workers contracted the ailment (Jacobs et al., 2015). The example of the Ebola crisis underscores the risks that health workers are exposed to as they deliver treatment. Since it is a highly contagious infection, TB is a particularly serious hazard that healthcare workers face. Numerous scholars have conducted studies which establish that health workers in various medical settings face the risk of contracting TB from their patients. For instance, joining forces with other scholars, McCarthy, Scott and Gous (2015) established that compared to the general population, health workers face an elevated risk of contracting TB. They point out that “health care workers (HCWs) are at two-fold greater risk of acquiring tuberculosis (TB) disease than the general population” (McCarthy et al., 2015, p. 647). McCarthy and his team examined the situation of South African health workers. It appears that the hazard of contracting TB is not confined to South Africa. The practitioners in such other countries as Peru are also exposed to this risk (Cabezas et al., 2017). It is evident that TB is a risk to all health works, regardless of the countries in which they operate.
The discussion above has revealed that most healthcare workers are exposed to the risk of contracting TB from their patients. While this remains true, it is helpful to remember that there are certain medical settings that expose the practitioners to a greater risk of contracting TB. Practitioners who work in low-income countries are among those who face the highest risk of acquiring TB from their patients (Zaman, 2010). In these countries, the structures and processes needed to insulate practitioners against hazards are lacking. Moreover, the prevalence rates of TB are higher in poor countries. This means that the practitioners are more likely to encounter patients ailing from TB. Practitioners who work with vulnerable patient populations also need to be wary of contracting TB. For example, medical professionals who attend to asylum seekers in Germany have been shown to face a very high risk of acquiring TB (Diel, Loddenkemper & Nienhaus, 2016). It is true that Germany has stable and well-developed health infrastructure. Despite this fact, the country’s health care workers continue to face the risk of contracting TB. The situation in Germany highlights the fact that it is nearly impossible for health workers to escape the threat of acquiring TB.
The lack of reliable medical infrastructure is just one of the risk factors that expose health workers to the threat of TB. Lack of knowledge among practitioners regarding the measures that they can institute to protect themselves against this infection is another risk factor (Gizaw, Alemu & Kibret, 2015). Such measures as wearing protective masks have been established as effective interventions that insulate practitioners (Hasanah, Setiawati & Apriani, 2016). Without knowledge on such interventions as the use of protective masks, the health workers are unable to stay safe. The conditions in which healthcare workers operate could also expose them to elevated risks of acquiring TB. When the operating conditions lack such facilities as respirators and soap, the practitioners may contract TB from patients (Engelbrecht et al., 2015). Overall, poor working conditions and working with vulnerable patient populations are some of the risk factors for TB among health workers.
The purpose of this paper is to establish that lack of knowledge regarding the health status of patients is among the major factors that expose health workers to the risk of TB. Numerous scholars have examined this question. Focus has been given to the reasons why the health workers lack knowledge on the ailments of their patients. The fact that some patients refuse to share their status with their physicians is among these reasons. TB usually accompanies such ailments as HIV/AIDS (Kaufmann & Walker, 2009). Out of fear of discrimination, many patients are reluctant to open up about their HIV status (Von Delft et al., 2014). Their hesitance makes it difficult for health workers to establish if they are also ailing from such opportunistic infections as TB. Front-line practitioners who are the first to attend to HIV positive patients are particularly vulnerable to contracting TB (Von Delft et al., 2014). If the medical profession is to make sustainable progress in tackling TB, there is need to address the negative perspectives associated with HIV.
Such developing countries as Uganda have weak healthcare systems that hamper efforts to deliver treatment to patients ailing from TB. The health workers in this country also suffer. It has been revealed that these workers are not fully informed on the threat of TB (Wynne et al., 2014). Moreover, these workers lack the facilities and services needed to accurately diagnose patients with TB. The shortcomings in the Ugandan healthcare system are to blame, at least in part, for the transmission of TB from patients to health workers. Delays in the diagnosis of patients with TB have also received blame for the transmission of the infection from patients to health workers (Almeida, Skupien & Silva, 2015). Since delays in diagnosis are among the factors responsible for patient-health worker transmission of TB, it follows that to address this problem, practitioners need to fast-track diagnosis. It is also important for patients to disclose information that will help the health workers to make accurate diagnosis. The challenge of fixing the problem of the transmission of TB cannot be left to health workers alone. All concerned stakeholders must join forces to rid medical institutions of health hazards.
The literature review offered above is indeed extensive. A number of insights can be gleaned from the review. One, TB is a serious threat to public health. Millions of individuals contract the illness every year. There are others who have developed drug-resistant strains of the disease. Two, inefficiencies in the health care systems of poor countries increase the risk of contracting TB. Three, developed nations are not safe from patient-practitioner transmission of TB. In such developed countries as Germany, health workers face the threat of contracting TB from asylum seekers. Overall, health workers are vulnerable to TB due to structural failures and lack of knowledge about the health status of patients.
Methods
As they conduct their studies, researchers are advised to use established methods and procedures. A study carried out by Shrestha et al. (2017) was reviewed as the authors explored the knowledge, attitudes, and practices of health care workers on TB infection control. This advice was heeded during the conduct of the research that this paper explores. Shrestha et al. (2017) used an institution-based cross-section survey in their study. Alongside the extensive literature review above, a wide variety of scholarly publications were examined for insight. The review was limited to publications that were relevant and recent. In particular, Shrestha et al. (2017) found that the level of knowledge of TB infection control among half of the HCWs was poor, and that the situation worsened when it came to administration and lower level staff. Additionally, the level of knowledge was linked to educational status, as well as the level of TB training or orientation given.
The review above revealed that a worrying number of health workers do not know that their patients are ailing from TB. This lack of knowledge increases the risk of the health workers contracting TB. Without the knowledge, the health workers are unable to take precautions such as isolating the patient. Overall, the review helps to establish this research. It enables the research to echo findings that other scholars have established after conducting thorough research. Notably, a literature review allows a researcher to obtain insights on the subject being examined. However, one of the flaws of literature review is that it is not provide primary insights. If it is that the literature reviewed was inaccurate, the researcher will replicate the inaccuracies in their own study. To ensure accuracy, Shrestha et al. (2017) used primary methods of data collection, which involved having respondents take the survey. Health workers who attend to patients with TB were interviewed. They were provided with questionnaires which sought to extract information from the workers regarding their experiences. One of the questions posed to the workers concerned their thoughts regarding the factors that increase the risk of contracting TB from patients. Basically, the participants needed to provide yes/no responses to the following question: “Do you think that lack of knowledge that a patient has TB increases the exposure of health workers to this infection?”. In compliance with established standards for research involving human subjects, the consent of the health workers was obtained before the questionnaire was administered. The Armstrong Institutional Review Board reminds researchers to “ensure the safety, protection and rights of participants” (“Institutional Review Board”, n.d). Apart from obtaining consent, researchers also need to be transparent. They should clearly communicate the purpose of their study and the roles that the participants will be required to perform. For this study, the health workers were informed that the main objective of the research was to establish how the lack of knowledge regarding patient health affects the health worker exposure to TB. Apart from ethical guidelines, there are legal provisions which dictate how researchers should conduct their studies. For instance, one of the provisions of the Health Insurance Portability and Accountability Act (HIPAA) is that patient privacy and confidentiality should be guaranteed at all times (Gkoulalas-Divanis & Loukides, 2015). As part of efforts to comply with this requirement, all the information that the participants provided was accorded utmost confidentiality. The participants were not asked to provide any personal or sensitive information such as their names. Overall, this research complied fully with all relevant standards and ethical guidelines which govern the conduct of studies involving human subjects.
The administration of the questionnaires and in the study in question the literature review only allowed for the collection of data. Once the data is collected, a researcher needs to conduct a thorough analysis. The purpose of the analysis is to extract useful insights from the collected data. The data analysis protocol adopted for this research was rather simple. Essentially, the analysis involved examining the data from the questionnaires and the literature review. If a majority of the health workers agreed that the lack of knowledge increases exposure to TB, it would be concluded that this is true. On the other hand, if most of the participants feel that the lack of knowledge does not expose workers to the risk of TB, there is a basis to conclude that the lack of knowledge has no significant impact on the experiences and health outcomes of the health workers.
Discussion
The methods adopted revealed an interesting relationship between health worker knowledge of patient health status and the exposure to TB. Nearly all the literature that was reviewed confirmed that TB is a serious illness. Left untreated, this illness can cause death. Health workers who interact with patients with TB face the risk of contracting this infection. While all such health workers are vulnerable, there are some who are more susceptible. For example, health workers in poor nations face a greater risk of acquiring TB (Wyne et al., 2014) . In these countries, such ailments as HIV are prevalent. The stigma that HIV patients endure discourages them from disclosing that they are ailing from TB. The health workers treating these patients are therefore exposed to the threat of TB. Another insight that the literature review revealed concerns the question of training. Many practitioners are not adequately trained on such issues as the symptoms of TB and the measures that are effective in containing the spread of this infection. Without the training, it is nearly impossible for the practitioners to accurately diagnose TB and keep themselves safe (Cabezas et al., 2017) . It is clear that the challenges that health workers face when treating TB patients are deeply rooted. The failures of educational institutions and medical facilities to invest in training compound the challenges that the health workers grapple with. This is particularly true in poor countries which lack the resources needed to train health workers (Cabezas et al., 2017) . For meaningful progress to be made in the effort against TB, all stakeholders should join health workers in treating TB patients.
The discussion above has focused on the insights that were gained from the literature review. The questionnaires that were administered also shed light on intriguing issues. Most of the health workers who participated in the research were of the view that the lack of knowledge that a patient has an infection exposes the workers to TB. This finding is in line with the revelation from the literature review. According to the finding, unless a health worker knows that a patient has TB, it is difficult for the worker to contain the spread of this disease (Shrestha et al., 2017). Some of the participants shared their own experiences with TB patients. There is a particular nurse who opened up about an incident where she was forced to attend to a patient who was visibly sick. The patient complained of pain in the chest area, persistent cough and chills. Despite these symptoms pointing to TB, the nurse still attended to the patient without any protection such as a face mask. While the nurse did not contract TB, her experiences highlight the role that hospital policy plays in exposing health workers to TB. It appears that hospitals prioritize the wellbeing of patients at the expense of the health of their practitioners.
Not all of the participants thought that lack of knowledge exposes health workers to TB. There are a few who responded that lack of knowledge plays no role. As part of follow-up, these participants were asked to offer their thoughts on the factors that they found responsible for the exposure of health workers to TB. They identified such factors as failure to follow laid-down diagnostic procedures and lack of containment facilities as the main risk factors for TB transmission from patients to health workers. It is important to note that these participants did not rule out lack of knowledge that the patient has TB. Instead, they felt that there are other factors that play a more prominent role in exposing health workers to TB. The views of these participants broaden the discussion on the experiences of health workers who treat TB patients. Thanks to their views, it is evident that the question of the transmission of TB among practitioners is complex; there are a wide range of forces which define whether and how the health workers contract the infection.
The conduct of this research was not perfect. There are various flaws and shortcomings that raise questions about the validity and reliability of the findings. The use of questionnaires is one of the flaws. The questionnaires allowed the participants to provide personal responses. Since these responses were self-reported, it is impossible to establish their accuracy. One simply has to trust that the participants provided accurate responses. Another flaw concerned the simplistic data analysis method that was applied. No complex mathematic or statistical procedures were used. It is therefore difficult to establish with certainty that there is a statistically significant association between knowledge regarding patient TB status and the risk of contracting this illness. Despite these shortcomings, the research is generally insightful and adds to the existing body of scholarly knowledge.
Conclusions
This research has been an enlightening and rewarding experience. It has shed light on the experiences of practitioners who work with TB patients. Thanks to the research, it has been established that the practitioners encounter many challenges. The challenges include inadequate resources, unfair hospital policies and patient failure to cooperate and seek treatment. The research has also highlighted the need for practitioner-centric interventions. It is important for medical facilities to provide their health workers with all the resources and support that they need to stay safe. The research relied on data from published literature and the questionnaire that was administered. The search for data presented a number of hurdles. For example, it was difficult to find publications that focus on TB in Western countries. Most of the articles reviewed address TB in the developing world. A possible explanation for this is that TB is a bigger problem in the developing world than it is in the West.
This research has unearthed interesting issues that require attention and action. The research has particularly highlighted the need for action from all stakeholders. Such actors as hospital administrators and governments appear to have abandoned health workers. These workers shoulder the responsibility of treating TB patients without much support. The war against TB will not be won if the health workers continue to work alone. The academic community also has a role to play. There is need to conduct research which will fill the numerous gaps. For example, there is minimal research on TB in the West. Researchers need to investigate how Western health workers cope with the challenge of treating TB patients. Overall, this research has presented many lessons. It has made it clear that health workers are brave and selfless individuals who place their own health at risk as they treat TB patients. The research has also underscored the need for greater investments in the health systems of developing nations. The increased investment will boost the capacity of the health workers to deliver care without running the risk of contracting TB and other infectious diseases.
References
Almeida, C. P. B., Skupien, E. C. & Silva, D. R. (2015). Health Care Seeking Behavior and Patient Delay in Tuberculosis Diagnosis. Cad. Saúde Pública, 31 (2).
DOI: http://dx.doi.org/10.1590/0102-311X00195413
Cabezas, S. M. G., Escate, M. C. V., Herrera, C. J., Romero, L. S. L., & Moore, D. (2017). Prevalence of Latent Tuberculosis Infection in Health Workers from Primary Health Care Centers in Lima, Peru. Revista peruana de medicina experimental y salud publica, 34 (4), 649-654.
Diel, R., Loddenkemper, R., & Nienhaus, A. (2016). Consequences of Tuberculosis among Asylum Seekers for Health Care Workers in Germany. Journal of Occupational Medicine and Toxicology, 11 (4). DOI: https://doi.org/10.1186/s12995-016-0093-x
Engelbrecht, M., Rensburg, A., Rau, A., Yassi, A., Spiegel, J., & O’Hara, L. (2015). Tuberculosis and Blood-Borne Infectious Diseases: Workplace Conditions and Practices of Healthcare Workers at three Public Hospitals in the Free State. Southern African Journal of Infectious Diseases, 30 (1), 23-28.
Gizaw, G. D., Alemu, Z. A., & Kibret, K. T. (2015). Assessment of Knowledge and Practice Of Health Workers towards Tuberculosis Infection Control and Associated Factors In Public Health Facilities of Addis Ababa, Ethiopia: A Cross-Sectional Study. Archives of Public Health, 73 (15). DOI: https://doi.org/10.1186/s13690-015-0062-3
Gkoulalas-Divanis, A., & Loukides, G. (2015). Medical Data Privacy Handbook. New York: Springer.
Hasanah, H., Setiawati, E. P., & Apriani, L. (2016). Knowledge and Intention to Use Personal Protective Equipment among Health Care Workers to Prevent Tuberculosis. Althea Medical Journal, 3 (1), 120-5. DOI: 10.15850/amj.v3n1.713
Jacobs, M., Aarons, E., Bhagani, S., Buchanan, R. et al. (2015). Post-Exposure Prophylaxis Against Ebola Virus Disease with Experimental Antiviral Agents: A Case-Series of Health-Care Workers. The Lancet, 15 (11), 1300-1304.
Kaufmann, S. H. E., & Walker, B. D. (2009). AIDS and Tuberculosis: A Deadly Liaison. Hoboken, NJ: Wiley.
McCarthy, K. M., Scott, L. E., Gous, N., Tellie, M., Venter, W., D., Stevens, W. S., & Van Rie, (2015). High Incidence of Latent Tuberculosis Infection among South African Health Workers: An Urgent Call for Action. The International Journal of Tuberculosis and Lung Disease, 19 (6), 647-653.
Raviglione, M. C. (2016). Tuberculosis: The Essentials. Fourth Edition. Boca Raton, FL: CRC Press.
Shrestha, A., Bhattarai, D., Thapa, B., Basel, P., & Wagle, R. R. (2017). Health care workers’ knowledge, attitudes and practices on tuberculosis infection control, Nepal. BMC Infectious Diseases , 17 , 724. http://doi.org/10.1186/s12879-017-2828-4
Von Delft, A., Dramowski, A., Khosa, C., Kotze, K. et al. (2014). Why Healthcare Workers are Sick of TB. International Journal of Infectious Diseases, 32 , 147-151.
World Health Organization (WHO). (2018). Tuberculosis. Retrieved March 14, 2018 From http://www.who.int/mediacentre/factsheets/fs104/en/
Wynne, A., Richter, S., Banura, L., & Kipp, W. (2014). Challenges in Tuberculosis Care in Western Uganda: Health Care Worker and Patient Perspectives. International Journal of Africa Nursing Sciences, 1, 6-10.
Zaman, K. (2010). Tuberculosis: A Global Health Problem. Journal of Health, Population and Nutrition, 28 (2), 111-113.
