Staff Survey
TB Infection Control at the Church of Scotland Hospital
This questionnaire is part of an effort to assess TB infection control knowledge, attitudes and practices of staff at the Church of Scotland Hospital. It is not a test. No one is evaluating you. Before we begin to implement a TB infection control plan, we want to see what staff at the hospital already know, think and do in relation to infection control in order to properly monitor and evaluate progress in the plan when it is implemented.
Confidentiality and anonymity
This questionnaire is COMPLETELY CONFIDENTIAL AND ANONYMOUS. You will not put your name on this questionnaire. You will make up your own ID number to put on the survey. No one will know the secret code except you. Please make sure you remember this code, as you will have to write it again in a few months when we take another survey. Use a number you will never forget, and consider storing the number on your cell phone. No one will keep track of what you wrote individually. When you are finished with the questionnaire, you can drop it in the box at the front of the room so no one will see which one is yours.
Your answers will not be shared with anyone else from this hospital, the Department of Health or elsewhere—neither your peers nor any of your superiors. Nothing you write in this survey will have any impact on your employment at COSH or anywhere else.
Honesty
There are no right or wrong answers. We only want the truth. We want to know what you actually think, feel and do in relation to TB infection control—not what you are supposed to think, feel and do! Being dishonest will only waste everyone’s time and money and lead to a poor TB infection control policy. This is bad for patients and for staff, as it puts everyone at risk of catching TB in the hospital.
Please do not give answers that you think we want to hear. Please only tell us the truth. No one in the world will know what you say on this survey and it will have no impact on your employment at COSH or elsewhere.
Questions
We have used some technical terms in this form. Please feel free to ask about anything you don’t understand. If you have any questions, you can contact Zahir Kanjee or Sister Kathryn Catterick.
We ask for your complete attention when you fill out this confidential questionnaire. Please fill it out honestly. No one will know what you wrote. Your results will not be shared with anyone and they will have no impact on your employment at COSH or elsewhere.
Thank you for improving TB infection control at COSH by completing this survey! Your colleagues and patients thank you.
Demographics
None of this data will be used to identify you personally. Please be honest when you answer these questions.
D1. Which department do you work in most of the time? (Circle only one.)
OPD [a]
Male TB [b]
Female TB [c]
MDR-TB [d]
ARV clinic [e]
Radiology [f]
Mortuary [g]
Dentistry [h]
Gateway [i]
Male Medical [j]
Female Medical [k]
Trauma [l]
D2. What is your job title? (Circle only one.)
Professional Nurse [a]
Enrolled Nurse [b]
Enrolled Nursing Assistant [c]
Ward clerk [d]
DOTS tracer [e]
D3. How long have you been a nurse/nurse assistant/clerk/tracer (not just at COSH, but anywhere)? (Circle only one.)
Less than 6 months [a]
Greater than 6 months-1 year [b]
Greater than 1 year- 5 years [c]
Greater than 5 years- 10 years [d]
Greater than 10 years- 20 years [e]
Greater than 20 years [f]
D4. Gender:
Male [a]
Female [b]
Knowledge/Information
The following questions are about TB. If you don’t know an answer, please do not guess. Instead, choose the “I don’t know” option.
Please answer honestly. Remember that your answers are COMPLETELY CONFIDENTIAL AND ANONYMOUS. No one will know what you wrote, and your answers will have no impact on your employment at COSH or elsewhere.
K1. Are the following symptoms of TB? (For each symptom, check only one—either “yes”, “no”, or “I don’t know”.)
Symptom / Yes, a symptom of TB [a] / No, not a symptom of TB [b] / I don’t know [c]Blurry vision / [1]
Coughing for longer than 2 weeks / [2]
Coughing up blood / [3]
Dizziness / [4]
Ear pain / [5]
Fever / [6]
Headache / [7]
Many bacterial infections / [8]
Memory loss / [9]
Night sweats / [10]
Pain with urination / [11]
Tiredness/ malaise / [12]
Watery eyes / [13]
Weight loss / [14]
K2. Are the following statements true or false? (For each option, check only one—either “true”, “false”, or “I don’t know”)
Statement / True [a] / False [b] / I don’t know [c]TB is often spread from person to person through sex / [1]
TB is often spread from person to person through the air / [2]
TB is often spread from person to person through blood / [3]
HIV-positive patients are more vulnerable to catching TB than HIV-negative patients / [4]
K3. Are the following statements true or false? (For each option, check only one—either “true”, “false”, or “I don’t know”)
Statement / True [a] / False [b] / I don’t know [c]Usually, only people with active TB disease in the lungs or throat are infectious / [1]
Patients with active TB disease can infect people by coughing / [2]
Patients with active TB disease can infect people by sharing food or drinks / [3]
Patients with active TB disease can infect people by spitting / [4]
Patients with active TB disease can infect people by sharing bed linens or toilet seats / [5]
Patients with active TB disease can infect people by talking / [6]
Patients with active TB disease are more likely to infect others if they have a cough that produces a lot of sputum / [7]
Very young children (less than 5 years of age) with active TB disease are usually infectious / [8]
K4. Is this an N95 or a surgical mask?
N95 [a]
Surgical mask [b]
I don’t know [c]
K5. Is this an N95 or a surgical mask?
N95 [a]
Surgical mask [b]
I don’t know [c]
K6. Are the following statements true or false? (For each option, check only one—either “true”, “false”, or “I don’t know”)
Statement / True [a] / False [b] / I don’t know [c]N95s protect healthcare workers and visitors by stopping TB particles from being breathed in / [1]
N95s must be thrown away after each day’s use / [2]
A wet or dirty N95 can still be used / [3]
An N95 should be stored in a plastic bag when it is not being used / [4]
Healthcare workers should write their names and dates on an N95 when they get it so they know which one is theirs / [5]
Surgical masks protect healthcare workers and visitors by stopping TB particles from being breathed in / [6]
It is alright to wear a beard (amadevu) or facial hair with an N95 / [7]
Surgical masks keep TB patients from coughing TB particles into the air / [8]
If mixing/extractor fans and ventilators are on in a room, it is NOT necessary to keep doors and windows open in order to prevent the spread of TB / [9]
K7. How often should you check if your N95 is airtight and doesn’t allow any air to pass/leak? (Check only one option.)
Never [a]
Every time you put on an N95 [b]
Once a week [c]
Once a month [d]
Once a year [e]
I don’t know [f]
K8. Where do most MDR-TB and XDR-TB patients catch MDR and XDR disease? (Check only one option.)
Inside the hospital [a]
In the community (outside of the hospital) [b]
I don’t know [c]
The following questions are about infection control practices. Think about the answers for a little while and write an answer if you can. The answer should be about 2 to 5 lines long. If you cannot think of anything at all, you may leave the question blank.
Remember that your answers are COMPLETELY CONFIDENTIAL AND ANONYMOUS. No one will know what you wrote, and your answers will have no impact on your employment at COSH or elsewhere.
K9. What should you tell a coughing patient to do in order to prevent the spread of TB and other respiratory infections?
K10. What item should you give to TB suspects or cases to prevent the spread of TB?
K11. Imagine you are in a room with TB patients. What item could you put on yourself to prevent TB infection?
K12. Imagine you are in a room with TB patients. What could you do to the room to prevent the spread of TB?
STOP- END OF SECTION
Attitude/Motivation
The following questions ask about your feelings about TB infection control practices. Please answer honestly, indicating how strongly you agree or disagree with the following statements. Please circle only one answer option per question.
These next questions ask how comfortable you are with some practices. Being comfortable means that you feel safe and not bothered to do it. You have no problem doing that activity for any reason. Please circle only one option per question.
Please answer honestly. Remember that your answers are COMPLETELY CONFIDENTIAL AND ANONYMOUS. No one will know what you wrote, and your answers will have no impact on your employment at COSH or elsewhere. Please tell us how you really feel—not how you are supposed to feel!
A1. .
A2. I feel comfortable asking every patient I see if they have any signs or symptoms of TB.
Strongly agree [a]
Agree [b]
Neutral [c]
Disagree [d]
Strongly disagree [e]
A3. .
A4. I feel comfortable offering TB tests to all patients who have TB signs or symptoms.
Strongly agree [a]
Agree [b]
Neutral [c]
Disagree [d]
Strongly disagree [e]
A5. I feel comfortable leaving doors open to prevent the spread of TB.
Strongly agree [a]
Agree [b]
Neutral [c]
Disagree [d]
Strongly disagree [e]
A6. I feel comfortable leaving windows open to prevent the spread of TB.
Strongly agree [a]
Agree [b]
Neutral [c]
Disagree [d]
Strongly disagree [e]
A7. If I were to develop symptoms of TB, I would feel comfortable requesting TB diagnosis from COSH.
Strongly agree [a]
Agree [b]
Neutral [c]
Disagree [d]
Strongly disagree [e]
A8. If I were to develop symptoms of TB, I would feel comfortable requesting TB diagnosis from another facility.
Strongly agree [a]
Agree [b]
Neutral [c]
Disagree [d]
Strongly disagree [e]
A9. If I were to develop symptoms of TB, I would hide them for as long as I could instead of getting a diagnosis.
Strongly agree [a]
Agree [b]
Neutral [c]
Disagree [d]
Strongly disagree [e]
A10. If I were HIV-positive and working in a high-risk TB area, I would feel comfortable asking my supervisor to be relocated.
Strongly agree [a]
Agree [b]
Neutral [c]
Disagree [d]
Strongly disagree [e]
A11. I would feel comfortable accepting confidential VCT from the COSH occupational health officer or an EAP sister.
Strongly agree [a]
Agree [b]
Neutral [c]
Disagree [d]
Strongly disagree [e]
A12. If COSH organized confidential VCT at another facility where no one knew me, I would feel comfortable testing my HIV status this way.
Strongly agree [a]
Agree [b]
Neutral [c]
Disagree [d]
Strongly disagree [e]
A13. If COSH provided home HIV testing kits for me to use at my house, I would feel comfortable accepting and using this kit to test my HIV status.
Strongly agree [a]
Agree [b]
Neutral [c]
Disagree [d]
Strongly disagree [e]
A14. .
A15. If COSH brought a mobile VCT unit to the hospital, and no one in the mobile unit knew me, I would feel comfortable getting an HIV test there.
Strongly agree [a]
Agree [b]
Neutral [c]
Disagree [d]
Strongly disagree [e]
A16. I feel comfortable telling coughing patients to follow cough hygiene procedures (like giving surgical masks or tissues, or telling them to cover their mouths with their arms when they cough or sneeze).
Strongly agree [a]
Agree [b]
Neutral [c]
Disagree [d]
Strongly disagree [e]
A17. I feel comfortable advising every patient to accept VCT.
Strongly agree [a]
Agree [b]
Neutral [c]
Disagree [d]
Strongly disagree [e]
A18. .
A19. I feel comfortable making TB suspects and cases wear surgical masks when in the hospital.
Strongly agree [a]
Agree [b]
Neutral [c]
Disagree [d]
Strongly disagree [e]
A20. I feel comfortable making visitors of TB patients wear surgical masks.
Strongly agree [a]
Agree [b]
Neutral [c]
Disagree [d]
Strongly disagree [e]
A21. I feel comfortable making visitors of TB patients wear N95s.
Strongly agree [a]
Agree [b]
Neutral [c]
Disagree [d]
Strongly disagree [e]
A22. If I were performing an autopsy/post-mortem, I would feel comfortable wearing an N95 every time.
Strongly agree [a]
Agree [b]
Neutral [c]
Disagree [d]
Strongly disagree [e]
A23. It is very distressing to me that female MDR-TB and XDR-TB patients are admitted into the general female TB ward because there is no female isolation ward.
Strongly agree [a]
Agree [b]
Neutral [c]
Disagree [d]
Strongly disagree [e]
A24. Because COSH does not use ultraviolet (UV) lights, I feel that the hospital is putting healthcare workers at higher risk of catching TB. (Note: If you do not know what UV lights are, please choose option “a”.)
I do not know what UV lights are [a]
Strongly agree [b]
Agree [c]
Neutral [d]
Disagree [e]
Strongly disagree [f]