4.6.1. Good Ventilated Working Environment
TB is transmitted through airborne routes. Poorly designed or overcrowded healthcare facilities play an important role in TB transmission and also increases the chances of cross-infection between patients and healthcare workers. HCWs are essential in the fight against TB infection and they should be protected. A good ventilated working environment should have natural, mechanical, and negative pressure ventilation to reduce the risk of spreading TB infection in the wards. Natural ventilation relies on open doors and windows to bring fresh air in the wards from outside, which dilutes the concentration of particles such as droplet nuclei containing Mycobacterium tuberculosis.
Nurse (N6) said: “the building where TB wards are allocated is old and needs refurbishment. The infrastructure is very old and not user friendly for implementing principles of infection control. Our biggest concern is that the TB wards are perpetuating the spread of infection. The management promised us that they will build new TB wards that are well ventilated, that have good airflow, fans and regularly serviced UV lights as well as big windows and patients’ waiting area to allow airflow. The wards will have nursing station and there will be a demarcation between TB, MDR-TB and XDR-TB. We really need those wards because we are not safe here.”
The findings of this study revealed that nurses need well-ventilated TB wards in the hospital. The TB wards layout was not suitable and lacked ventilation, which increased risk of TB spread. The working environment was not safe and did not meet the national standards guidelines for a TB ward setting, as recommended by South Africa [31]. According to the study by Narasimhan et al. [32], overcrowding and poorly ventilated environments increase the risk of acquiring TB.