Registered nurses' role in diagnosing childhood tuberculosis in South Africa

Abstract

Childhood tuberculosis is an increasingly important public health problem and is a major cause of morbidity and mortality in developing countries, contributing to a significant increase in the burden of disease worldwide. TB is particularly difficult to diagnose in children. Sputum induction as a diagnostic method is feasible, effective and well tolerated in children and has become the preferred standard diagnostic investigation at most paediatric hospitals for suspected pulmonary TB. This article describes registered nurses' experiences of their role regarding the induced sputum procedure to diagnose childhood TB. A sample of six South African registered nurses participated in the exploratory, descriptive, qualitative study. The main research question was: What are registered nurses' experiences regarding their role in sputum induction for diagnosing childhood TB in a secondary hospital setting in South Africa? Data were collected using a semi-structured interview guide and field notes. The interview guide was pre-tested with two participants. A qualitative thematic analysis method was used to analyse the transcribed interviews and field notes. The following six themes emerged from the analysed data pertaining to the roles of the registered nurses: involving the mother or caregiver, assessment and monitoring, controlling the spread of infection, active participation in diagnosing TB, teaching/training and saving money. These findings highlight the important roles played by nurses in conducting the sputum induction procedure for the diagnosis of childhood TB, the need to train more nurses to perform the procedure effectively, and to include the sputum induction procedure in the undergraduate nursing curriculum.