Date of Award

Spring 2020

Document Type

Open Access Thesis


Epidemiology and Biostatistics

First Advisor

Eric Brenner


BACKGROUND: Every year tuberculosis (TB) causes over 10 millions of people globally and in recent years has caused over 9,000 cases annually in the United States. TB can be transmitted in hospital settings, and South Carolina hospitals, like hospitals elsewhere in the country maintain a responsibility to test their employees for this disease. Nosocomial infections of active TB among patients and healthcare workers can be burdensome on hospital resources. Testing healthcare workers and implementing prevention strategies are examples of administrative controls provided in the 2005 guidelines by the Centers for Disease Control and Prevention (CDC). Implementation of administrative controls are considered the most important and are the first tier of the hierarchical control strategies for preventing TB transmission in healthcare settings.

OBJECTIVE: The purpose of this study was to review current employee TB screening practices in South Carolina hospitals, in particular to assess (i) whether they screen using the traditional tuberculin skin test or the newer Interferon Gamma Release Assay; and (ii) whether they have (or have not) performed a formal TB risk assessment following suggested administrative prevention controls from guidelines by the CDC.

METHODS: Utilizing the TB Risk Assessment for healthcare facilities, a questionnaire was designed and distributed via Survey Monkey with the assistance of the South Carolina Hospital Association (SCHA) to member South Carolina healthcare facilities (n=100).

RESULTS: Fifty-one health care facilities participated in the study. Forty-one facilities (84%) reported using the guidelines as a basis for employee TB testing, yet only thirty-four facilities (68%) stated that a formal risk assessment had been performed prior to the survey.

CONCLUSION: The majority of South Carolina hospitals surveyed are adhering to CDC testing guidelines for healthcare employees and conducting a formal risk assessment. Additional training and guidance with all hospital employees would be beneficial in providing consistency of policy implementation across the state. Implementation of administrative controls is critical in preventing TB transmission in hospitals.


© 2020, Tamara T. Carree