1 Maryland County Health Department Tuberculosis Infection Control Plan Introduction In 1998, the Division of TB Control developed a Tuberculosis (TB) Prevention Plan template for use by the local health departments in Maryland. Since that time there have been significant changes in recommendations from the CDC which reflect shifts in the epidemiology of TB and changes in health care practice in the United States. The following TB Infection Control Plan template has been updated to reflect those changes. All local health departments need a TB Infection Control Plan designed to ensure prompt detection and treatment of active TB that is based on a three-level hierarchy of controls, including administrative controls, environmental controls and respiratory protection. Administrative controls address policies aimed to reduce the risk for exposure to persons who might have TB disease. This includes assessment of the risk of TB exposure to individuals in the facility, development and implementation of a TB prevention and control plan based on the risk assessment, and education and screening of employees. Environmental controls include the use of measures such as local exhaust ventilation and airborne infection isolation rooms to prevent the spread and reduce the concentration of infectious TB droplet nuclei in the air. Respiratory protection controls include the training in, and use of respiratory protection equipment and respiratory hygiene. TB Infection Control Plans should be re-evaluated and updated as needed, but at least annually. Overall responsibility for the plan should be assigned to a specific staff position, and plans should be implemented in all local health departments. The template has been revised according to the latest CDC and OSHA recommendations regarding tuberculosis prevention and control for health care workers (HCW) and facilities; therefore, health departments may use the template by a) completing the missing information within the template, and/or b) modifying the template according to identified need. The template is available on line at and may be downloaded and completed electronically. Once the initial plan is completed, any subsequent change(s) can be made without rewriting the entire document. For any questions related to this template, please call the Maryland Department of Health and Mental Hygiene, Division of TB Control, Refuge and Migrant Health at
2 Maryland County Health Department TB Infection Control Plan This plan describes the administrative controls, environmental controls, and the respiratory protection program for the County Health Department. Refer to the Maryland TB Guidelines for Prevention and Treatment of Tuberculosis, 2007 for any TB Control activities not specifically addressed in this plan (i.e., when an employee can return to work after diagnosis of active TB). Administrative Controls 1. Responsibilities The various responsibilities for this plan are assigned to employees as identified in Attachment I. This plan will be reviewed and updated as needed and annually in (indicate month). 2. Risk Assessment Based on completion of the TB Risk Assessment Worksheet (Attachment II) and CDC Risk Classifications (Attachment III), risk assessment is assigned as follows 1 : Low risk in setting(s). Medium risk in setting(s). Potential ongoing transmission in setting(s) Screening of HCWs The frequency of screening for TB infection among staff follows CDC Risk Classification guidelines (Attachment III). Screening of HCWs is documented (Attachment IV or other similar form). Baseline Screening Baseline screening includes a two-step TST or single blood assay for Mycobacterium tuberculosis test (BAMT). Employees with documented previous positive TST or BAMT and documented normal CXR will receive a symptom screen. The following employee classifications are included in baseline screening (list identified employee classifications here): 1 Different risk classifications may be applied to separate clinical areas and/or separate classifications of employees. 2 This classification is temporary and warrants immediate investigation and corrective steps to stop ongoing transmission. Once transmission has ceased, the setting should be reclassified as medium risk for at least 1 year.
3 Annual Screening Annual screening includes a symptom screen for all identified employees and testing for TB infection for identified employees with previous negative TST or BAMT. Will be performed for the employee classifications listed below. Conversion rates are calculated annually, and any increase from the baseline rate will be investigated. (List identified employee classifications here.) Will not be performed (low risk settings only) for the employee classifications listed below. After baseline testing, further screening will occur only if a documented exposure to active TB occurs, or if there is a change in the risk assessment category. (List identified employee classifications here.) 4. Work Practice Controls Early Identification of Suspect TB Early identification of individuals suspected to have infectious TB is performed as indicated below. Once identified, individuals with suspected TB will be masked and isolated, and the individual will be referred for evaluation. Low risk setting. Individuals presenting for service in settings identified as low risk settings will not be screened unless they have signs or symptoms of TB. Medium risk setting. Individuals presenting for service in settings identified as medium risk settings with symptoms of TB or known HIV infection will be screened for TB. Potential for ongoing transmission of TB setting. All individuals presenting for service in settings identified as having the potential for ongoing transmission of TB will be screened for TB symptoms and risk factors. Individuals who are screened and who need further evaluation will be asked to wear a surgical or procedure mask, isolated and referred as follows: Location of isolation within facility. Transported for evaluation to:. Transportation provided by:. OR Evaluated on site by:.
4 Cough Hygiene Signs are posted in all waiting areas to remind individuals to Cover Your Cough (Attachment V or other similar). Employees have been trained, and are encouraged to provide tissues and remind individuals to cover coughs. Employee Education TB education is provided to employees upon hire and annually thereafter. The topics are listed on the TB Infection Control Training Record (Appendix VI or other similar) which is signed by the employee at each training session and kept in the employee s personnel record. The following employee classifications are included in TB education sessions (list employee classifications here): Environmental Controls General Ventilation Systems. Ventilation systems in use in the facility are described in the TB Risk Assessment Worksheet (Attachment II). A maintenance and repair log is kept. Airborne Infection Isolation (AII) Rooms. Ventilation systems have at least 6 ACH in existing health-care settings and at least 12 ACH in new construction or renovation of healthcare settings. Air is discharged outdoors or HEPA-filtered before recirculation. Room is under constant negative pressure which is monitored at least monthly, and daily when room is in use. A maintenance and repair log is kept. Sputum Induction Room. The sputum induction room meets the recommendations for AII room. If no AII room available, a fully enclosed sputum induction booth with local exhaust ventilation is used. Units are maintained according to manufacturers recommendations. A maintenance and repair log is kept. High Efficiency Particulate Air (HEPA) Filter Units. HEPA filter units are maintained according to manufacturers recommendations. A maintenance and repair log is kept. Ultraviolet Germicidal Irradiation (UVGI) Units. UVGI units are maintained according to manufacturers recommendations. A maintenance and repair log is kept.
5 Respiratory Protection Identified employees are required to wear NIOSH-certified N-95 respirators, in the following situations: In the presence of a suspected or confirmed infectious TB patient who is unable or unwilling to wear a mask. When entering a room, including an AII room, or a home which has been occupied by an unmasked person with suspected or confirmed infectious TB, prior to the time required for 99% of the airborne contaminants to be removed from the room (Attachment VII). When transporting or accompanying a person with suspected or known infectious TB in an enclosed vehicle, even if that person is wearing a surgical mask. In the presence of high-risk procedures (e.g., sputum induction). Identified employees receive instruction on when to wear the respirator, how to conduct a fitcheck, how to inspect, maintain, and store the respirator, when to dispose of the respirator, and respirator limitations. This instruction is documented on the TB Infection Control Training Record (Attachment VI). Initial fit-testing of respirators is performed by:. Periodic fit-testing of respirators is performed (indicate frequency). Fit-testing of respirators is performed by:. The following employee classifications are required to wear N-95 respirators during the activities described above (list identified employee classifications here): Date Plan Adopted/Revised Signature of Health Officer Signature of Person Responsible for Plan Signature of TB Controller (if different from person responsible)
6 Attachment I Assignment of Responsibilities for Local Health Department TB Control Plan Responsibility Employee Classification Responsible Review and update plan Perform risk assessment Provide employee education Assure all identified employees attend annual training and maintain training records Perform and document employee screening Assure all identified employees are screened and maintain screening records Monitor conversion rates (if annual screening being performed) and investigate any increase over baseline rate Monitor and replace as needed cough etiquette signs located in the facility Monitor negative pressure in AII room(s), document findings, report when pressure is not negative Monitor and maintain HEPA units, document and maintain records filter changes and repairs Monitor and maintain UVGI units and warning signage, document and maintain records of cleaning and changing of bulbs Provide fit testing Maintain fit-testing records and order masks and fit-test supplies Comply with all elements of this plan, including attending education sessions, obtaining required screening, using respirators when indicated, using safe work practices, and reporting all TB exposures All employees
7 Tuberculosis (TB) Risk Assessment Worksheet This worksheet was adapted from CDC guidelines. 3 should apply this table to each setting. Attachment II Facilities with more than one type of setting 1. Incidence of TB What is the incidence of TB in your community (county or region served by the health-care setting), and how does it compare with the state and national average? What is the incidence of TB in your facility and specific settings and how do those rates compare? (Incidence is the number of TB cases in your community the previous year. A rate of TB cases per 100,000 persons should be obtained for comparison.)* This information can be obtained from the state or local health department. Are patients with suspected or confirmed TB disease encountered in your setting (inpatient and outpatient)? If yes, how many patients with suspected and confirmed TB disease are treated in your health-care setting in 1 year (inpatient and outpatient)? Review laboratory data, infection-control records, and databases containing discharge diagnoses. If no, does your health-care setting have a plan for the triage of patients with suspected or confirmed TB disease? Currently, does your health-care setting have a cluster of persons with confirmed TB disease that might be a result of ongoing transmission of Mycobacterium tuberculosis within your setting (inpatient and outpatient)? Community rate State rate National rate Facility rate Department 1 rate Department 2 rate Department 3 rate Year No. patients Suspected Confirmed 1 year ago 2 years ago 5 years ago Yes No 2. Risk Classification Does your health-care setting provide care to TB patients? (If yes, a classification of at least medium risk is recommended for those employees who provide such care.) Does evidence exist that a high incidence of TB disease has been observed in the population that the health-care setting serves? Does evidence exist of person-to-person transmission of M. tuberculosis in the health-care setting? (Use information from case reports. Determine if any tuberculin skin test [TST] or blood assay for M. tuberculosis [BAMT] conversions have occurred among health-care workers [HCWs]). Does evidence exist that ongoing or unresolved health-care associated transmission has occurred in the health-care setting (based on case reports)? Is there a high incidence of immunocompromised patients or HCWs in the healthcare setting? Have patients with drug-resistant TB disease been encountered in your health-care setting within the previous 5 years? When was the first time a risk classification was done for your health-care setting? Year 3 CDC Guidelines for Preventing the Transmission of Mycobacterium tuberculosis in Health-Care Settings, MMWR 2005;54(No. RR-17):pp
8 3. Screening of HCWs for M. tuberculosis Infection Does the health-care setting have a TB screening program for HCWs? If yes, which HCWs are included ο Administrators in the TB screening program? ο Laboratory workers (Check all that apply.) ο Respiratory therapists ο Physicians ο Physical therapists ο Mid-level practitioners (nurse ο Contract staff practitioners [NP] and ο Construction or renovation physician s assistants [PA]) workers ο Nurses ο Service workers ο Janitorial staff ο Maintenance or engineering staff ο Transportation staff ο Dietary staff ο Receptionists ο Trainees and students ο Volunteers ο Others Is baseline skin testing performed with two-step TST for HCWs? Is baseline testing performed with QFT or other BAMT for HCWs? How frequently are HCWs tested for M. tuberculosis infection? Are the M. tuberculosis infection test records maintained for HCWs? Where are the M. tuberculosis infection test records for HCWs maintained? If the setting has a serial TB screening program for HCWs to test for M. tuberculosis infection, what are the conversion rates for the previous years? 1 year ago 4 years ago 2 years ago 5 years ago 3 years ago Has the test conversion rate for M. tuberculosis infection been increasing or decreasing, or has it remained the same over the previous 5 years? (check one) Do any areas of the health-care setting (e.g., waiting rooms or clinics) or any group of HCWs (e.g., lab workers, emergency department staff, respiratory therapists, and HCWs who attend bronchoscopies) have a test conversion rate for M. tuberculosis infection that exceeds the health-care setting s annual average? For HCWs who have positive test results for M. tuberculosis infection and who leave employment at the health setting, are efforts made to communicate test results and recommend follow-up of latent TB infection (LTBI) treatment with their primary physician? 4. TB Infection-Control Program When was the TB infection-control plan first written? When was the TB infection-control plan last reviewed or updated? Does the written infection-control plan need to be updated based on the timing of the previous update (i.e., >1 year, changing TB epidemiology of the community or setting, the occurrence of a TB outbreak, change in state or local TB policy, or other factors related to a change in risk for transmission of M. tuberculosis)? Does the health-care setting have an infection-control committee (or another committee with infection control responsibilities)? If yes, which groups are represented on the infection-control committee? (Check all that apply.) ο Physicians ο Nurses ο Epidemiologists ο Engineers ο Laboratory personnel ο Health and safety staff ο Administrator If no, what committee is responsible for infection control in the setting? ο Increasing ο Decreasing ο No change If yes, list Not applicable ο Pharmacists ο Risk assessment ο Quality control (QC) ο Others (specify) 5. Implementation of TB Infection-Control Plan Based on Review by Infection-Control Committee Through what means (e.g., review of TST or BAMT conversion rates, patient medical records, and time analysis) are lapses in infection control recognized? What mechanisms are in place to correct lapses in infection control?
9 Based on measurement in routine QC exercises, is the infection-control plan being properly implemented? Is ongoing training and education regarding TB infection-control practices provided for HCWs? 6. Environmental Controls Which environmental controls are in place in your health-care setting? (Check all that apply and describe) Environmental control Description ο AII rooms ο Local exhaust ventilation (enclosing devices and exterior devices) ο General ventilation (e.g., single-pass system, recirculation system.) ο Air-cleaning methods (e.g., high-efficiency particulate air [HEPA] filtration and ultraviolet germicidal irradiation [UVGI]) What are the actual air changes per hour (ACH) and design for various rooms in the setting? Room ACH Design Which of the following local exterior or enclosing devices such as exhaust ventilation devices are used in your health-care setting? (Check all that apply) ο Laboratory hoods ο Booths for sputum induction ο Tents or hoods for enclosing patient or procedure What general ventilation systems are used in your health-care setting? (Check all that apply) ο Single-pass system ο Variable air volume (VAV) ο Constant air volume (CAV) ο Recirculation system ο Other What air-cleaning methods are used in your healthcare setting? (Check all that apply) HEPA filtration ο Fixed room-air recirculation systems ο Portable room-air recirculation systems How many AII rooms are in the health-care setting? What ventilation methods are used for AII rooms? (Check all that apply) Primary (general ventilation): ο Single-pass heating, ventilating, and air conditioning (HVAC) ο Recirculating HVAC systems UVGI ο Duct irradiation ο Upper-air irradiation ο Portable room-air cleaners Secondary (methods to increase equivalent ACH): ο Fixed room recirculating units ο HEPA filtration ο UVGI ο Other (specify) Does your health-care setting employ, have access to, or collaborate with an environmental engineer (e.g., professional engineer) or other professional with appropriate expertise (e.g., certified industrial hygienist) for consultation on design specifications, installation, maintenance, and evaluation of environmental controls? Are environmental controls regularly checked and maintained with results recorded in maintenance logs? Are AII rooms checked daily for negative pressure when in use? Is the directional airflow in AII rooms checked daily when in use with smoke tubes or visual checks? Are these results readily available? What procedures are in place if the AII room pressure is not negative?
10 Do AII rooms meet the recommended pressure differential of 0.01-inch water column negative to surrounding structures? 7. Respiratory-Protection Program Which HCWs are included in the respiratory protection program? (Check all that apply) ο Physicians ο Mid-level practitioners (NPs and PAs) ο Nurses ο Administrators ο Laboratory personnel ο Contract staff ο Construction or renovation staff ο Service personnel ο Janitorial staff ο Maintenance or engineering staff ο Transportation staff ο Dietary staff ο Students ο Others (specify) Are respirators used in this setting for HCWs working with TB patients? If yes, include manufacturer, model, and specific application (e.g., ABC model 1234 for bronchoscopy and DEF model 5678 for routine contact with infectious TB patients). Manufacturer Model Specific application Is respiratory-protection training for HCWs performed by a person with advanced training in respiratory protection? What method of fit testing is used? Describe. Is qualitative fit testing used? Is quantitative fit testing used? 8. Reassessment of TB risk When was the last TB risk assessment conducted? What problems were identified during the previous TB risk assessment? 1) 2) 3) 4) 5) What actions were taken to address the problems identified during the previous TB risk assessment? 1) 2) 3) 4) 5) Did the risk classification need to be revised as a result of the last TB risk assessment? * If the population served by the health-care facility is not representative of the community in which the facility is located, an alternate comparison population might be appropriate. Test conversion rate is calculated by dividing the number of conversions among HCWs by the number of HCWs who were tested and had prior negative results during a certain period (see Supplement, Surveillance and Detection of M. tuberculosis infections in Health-Care Settings).
11 Attachment III CDC. Guidelines for Preventing the Transmission of Mycobacterium tuberculosis in Health-Care Settings, MMWR 2005; 54(No. RR-17):p13
12 HCW Tuberculosis Screening Form Attachment IV Today s Date Employee Name DOB HISTORY History of TB disease? Yes No Date Treatment History of TB infection? Yes No Date Treatment Previous TB test None TST Date Result mm GFT-G* Date Result (circle one) Positive Negative Indeterminate Previous CXR Date Result (circle one) Normal Abnormal Attach copy of CXR report. Allergies TST (Tuberculin Skin Test) #1 TST #2 (only if needed) QFT-G (*QuantiFERON-TB Gold blood assay for Mycobacterium tuberculosis instead of TST) Date Result (circle one) Positive Negative Indeterminate Attach copy of lab report. CXR (needed for any newly identified positive TST or QFT-G) Date Result (circle one) Normal Abnormal Attach copy of CXR report. SYMPTOM REVIEW (Initial) If any of the following symptoms are present, refer for medical evaluation Cough for more than 3 weeks? Coughing up blood? Chest pain or shortness of breath? Unexplained weight loss or poor appetite? Unexplained fever? Unexplained tiredness? Unexplained night sweats? DISPOSITION Negative TST or QFT-G, no further screening needed Negative TST or QFT-G, annual TST or QFT-G needed Positive TST or QFT-G, normal CXR (within past 6 months), no TB symptoms, annual symptom screen needed History of positive TST or QFT-G with normal CXR at the time, no TB symptoms, annual symptom screen needed Review of TB symptoms and written information provided (see for handouts) Positive TST or QFT-G with symptoms present and/or abnormal CXR, referred to Must have medical evaluation to rule out active TB before starting work Date Initials
13 Employee Name DOB SERIAL SCREENING Indicate Y (yes) or N (no) Date Cough for more than 3 weeks? Coughing up blood? Chest pain or shortness of breath? Unexplained weight loss or poor appetite? Unexplained fever? Unexplained tiredness? Unexplained night sweats? SERIAL TSTs
14 Attachment V
15 TUBERCULOSIS (TB) INFECTION CONTROL TRAINING RECORD Attachment VI Training Date Instructor Employee Initials 1. I know where the tuberculosis (TB) infection control plan (ICP) is kept and how to obtain a copy. 2. I know how TB is spread from person-to-person. 3. I know the signs and symptoms of TB. 4. I know the difference between TB infection and TB disease. 5. I am aware that health-care workers (HCWs) are at risk for TB infection and TB disease. 6. I know that diseases and drugs that affect the immune system increase the risk of TB infection progressing to TB disease. 7. I am responsible for following work practices discussed in this class and in the TB ICP. 8. I understand the purpose of testing for M. tuberculosis infection and TB symptom screening. 9. I know what to do if I see a coughing patient who has other signs or symptoms of TB. 10. I know that treatment for TB infection can reduce the risk of progressing to TB disease. 11. I know when to wear a respirator for protection against TB transmission, how to conduct a fit-check, how to inspect, maintain, and store the respirator, when to dispose of the respirator, and respirator limitations OR I am not required to wear a respirator to perform my assigned duties. 12. I know which environmental controls (ventilation, filters, ultraviolet lamps, AII rooms) are in place at this facility. 13. I know where to find safety and protective equipment (gowns, gloves), how to use this equipment, and how to dispose of it after use. 14. I know what multidrug-resistant (MDR) and extensively drug-resistant (XDR) TB are. 15. I know what the current TB case rates are for the community in which I work. 16. I have had an opportunity to have my questions answered about the above topics Employee Signature Date
16 Attachment VII CDC. Guidelines for Preventing the Transmission of Mycobacterium tuberculosis in Health-Care Settings, MMWR 2005; 54(No. RR-17):p20.
Appendix B. Tuberculosis (TB) risk assessment worksheet This model worksheet should be considered for use in performing TB risk assessments for healthcare facilities and nontraditional facility-based settings.
Montana DPHHS Tuberculosis Program Long-term Care - TB Risk Assessment Long-term Care, Residential Treatment, ESRD (outpatient), Hospice (inpatient) Today s Date Facility Address Phone County Completed
PEOSH Model Tuberculosis Infection Control Program Revised November, 2004 NOTE: The information in this document is not considered to be a substitute for any provision of the PEOSH Act or for any standards
Tuberculosis Exposure Control Plan for Low Risk Dental Offices A. BACKGROUND According to the CDC, approximately one-third of the world s population, almost two billion people, are infected with tuberculosis.
Montana DPHHS Tuberculosis Program Assisted Living - TB Risk Assessment Assisted Living, Adult Day Care, Adult Foster Care & Transitional Living Centers Today s Date Facility Address Phone County Completed
Maria Dalbey RN. BSN, MA, MBA March 17 th, 2015 2 Objectives Participants will be able to : Understand the Pathogenesis of Tuberculosis (TB) Identify the Goals of Public Health for TB Identify Hierarchy
Tuberculosis (TB) Screening Guidelines for Substance Use Disorder Treatment Programs in California 1 of 7 Table of Contents Preface 2 TB Symptoms and TB History 2 Initial Screening 2 Follow-Up Screening
TUBERCULOSIS (TB) SCREENING GUIDELINES FOR RESIDENTIAL FACILITIES AND DRUG Tx CENTERS Tuberculosis Control Program Health and Human Services Agency San Diego County INTRODUCTION Reducing TB disease requires
Guidelines for Preventing the Transmission of M. tuberculosis in Health-Care Settings, 2005 Division of Tuberculosis Elimination December 2006 note: Slide #123 has been edited. HCWs Who May Be Included
Targeted Testing for Tuberculosis Infection CONTENTS Introduction... 3.2 Purpose... 3.2 Policy... 3.2 When to Conduct Targeted Testing... 3.3 Approaches to increasing targeted testing and treatment for
October 28, 1994 / Vol. 43 / No. RR-13 Recommendations and Reports Guidelines for Preventing the Transmission of Mycobacterium tuberculosis in Health-Care Facilities, 1994 U.S. DEPARTMENT OF HEALTH AND
Please note: This report has been corrected and replaces the electronic PDF version that was published on December 30, 2005. Morbidity and Mortality Weekly Report Recommendations and Reports December 30,
Appendix D October 10, 2014 Infection Prevention and Control s for Hospitalized Patients with Known or Suspected Ebola Virus Disease in U.S. Hospitals Standard, contact, and droplet precautions are recommended
U.S. DEPARTMENT OF LABOR Occupational Safety and Health Administration DIRECTIVE NUMBER: CPL 02-02-078 EFFECTIVE DATE: 06/30/2015 SUBJECT: Enforcement Procedures and Scheduling for Occupational Exposure
Guidelines for TB Blood Testing Minnesota Department of Health TB Prevention and Control Program June 2011 Outline Interferon-Gamma Release Assays aka TB blood tests 1. What are they? 2. What are the current
Mississippi Downloaded 01/2011 101.11 Infectious Medical Waste. The term "infectious medical waste" includes solid or liquid wastes which may contain pathogens with sufficient virulence and quantity such
Chapter 8 Community Tuberculosis Control Table of Contents Chapter Objectives.... 227 Introduction.... 229 Roles and Responsibilities of the Public Health Sector Providers.... 229 Roles and Responsibilities
Regulations for Tuberculosis Control in Minnesota Health Care Settings A guide for implementing tuberculosis (TB) infection control regulations in your facility Tuberculosis Prevention and Control Program
Risk for Tuberculosis in Swiss Hospitals 17. Tuberkulose Symposium Münchenwiler Risk for Tuberculosis in Swiss Hospitals Dr. med. Alexander Turk Zürcher Höhenklinik Wald email@example.com 1 Content
U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES Public Health Service Centers for Disease Control and Prevention National Center for HIV, STD, and TB Prevention Division of Tuberculosis Elimination Public
Tuberculosis Surveillance and Screening for Long Term Care Facilities in Colorado Developed by the Colorado Medical Directors Association and The Colorado Department of Public Health and Environment Introduction:
Recommendations from the Minnesota Department of Health (MDH) for Completing the CDC Facility TB Risk Assessment Worksheet The Facility TB Risk Assessment Worksheet, developed by the Centers for Disease
Pocket Guide QuantiFERON -TB Gold CDC TB Testing Guidelines and Recent Literature Update Using IGRAs for TB screening in your patients June 2010 A full copy of the US Centers for Disease Control and Prevention
Introduction to TB Nurse Case Management Online February 4, 11, 18 and 25, 2015 TB Infectiousness and TB Isolation/Segregation Presented by Jenelle Leighton RN, BSN February 11, 2015 Jenelle Leighton RN,
Tuberculosis Exposures at Santa Clara Valley Medical Center May 11, 2016 Objectives To provide basic definitions of tuberculosis including differentiation between active tuberculosis disease and latent
Overview of Tuberculosis Epidemiology, Transmission, Clinical Presentation, and Treatment Tuberculosis Airborne disease caused by the bacterium Mycobacterium tuberculosis (M. tb) M. tb complex (MTBC) includes
ECDC INTERIM GUIDANCE Interim ECDC public health guidance on case and contact management for the new influenza A(H1N1) virus infection Version 3, 19 May 2009 ECDC intends to produce a series of interim
TB INSERVICE TEACHING PLAN Define TB Tuberculosis (TB) is an airborne infectious disease that is caused by a germ that gets into the lungs. TB is spread through casual contract. It is spread when the contact
Policy Directive: compliance is mandatory Policy for Control of Tuberculosis in South Australian Health Services Policy developed by: Public Health and Clinical Coordination Approved at Portfolio Executive
This Health Hazard Evaluation (HHE) report and any recommendations made herein are for the specific facility evaluated and may not be universally applicable. Any recommendations made are not to to be considered
Shelters and TB: What Staff Need to Know VIEWER S GUIDE SECOND EDITION, 2008 Shelters and TB: What Staff Need to Know VIEWER S GUIDE SECOND EDITION, 2008 The Francis J. Curry National Tuberculosis Center
MN DONA Spring Conference 4/16/2015 Regulatory Issues for Comprehensive Home Care in Assisted Living* MN-DONA Spring Conference April 16, 2015 Doug Beardsley Vice-President of Member Services Care Providers
TUBERCULOSIS INTRODUCTION Tuberculosis is an infectious disease caused by a bacterium, myobacterium tuberculosis. The disease is spread when people inhale droplets of saliva or mucous from infected people.
D Effects of CDC Guidelines on Tuberculosis Control in Health Care Facilities Keith F. Woeltje, M.D., Ph.D. SUMMARY In response to nosocomial outbreaks of tuberculosis among patients and health care workers,
Alternate Methods for USING GERMICIDAL UV-C Disinfection Lamps TO SUPPLEMENT HEPA Filtration By Dave Shagott Today, healthcare facilities must be prepared to face potential large-scale threats from chemical,
Influenza Control Program Frequently Asked Questions Wearing a Mask Influenza or the flu can be a serious contagious disease, which is spread by droplet transmission through close contact with an infected
Tuberculosis Contents Epidemiology in New Zealand 2 Case definition 2 Clinical description 2 Laboratory test for diagnosis 3 Case classification 3 Spread of infection 4 Incubation period 4 Mode of transmission
2012 1 MEMBERS OF THE NATIONAL TECHNICAL COMMITTEE FOR PREVENTION & MANAGEMENT OF TUBERCULOSIS FOR HEALTH CARE WORKERS IN MINISTRY OF HEALTH Advisor Chairman Secretary Dr. Lokman Hakim Bin Sulaiman Deputy
Table of Contents Education and Training Yale New Haven Health System Center for Healthcare Solutions 2009-2010 Fall/Winter Course Guide TOPICS firstname.lastname@example.org www.yalenewhavenhealth.org/healthcaresolutions
Tuberculosis Prevention and Control Protocol, 2008 Preamble The Ontario Public Health Standards (OPHS) are published by the Minister of Health and Long- Term Care under the authority of the Health Protection
Guidelines on Airborne Infection Control in Healthcare and Other Settings April 2010 Directorate General of Health Services Ministry of Health & Family Welfare Nirman Bhawan, New Delhi Guidelines on Airborne
C-6. Medical Surveillance I. Purpose The purpose of the medical surveillance of employees at the NCI-Frederick is to preserve health and prevent work related disease. The medical surveillance program will
3M Occupational Health and 3M Center, Building 235-02-W-70 Environmental Safety Division St. Paul, MN 55144-1000 651 733 1110 9/6/2006 Respiratory Protection and Avian Influenza Viruses Frequently Asked
STATE OF NEW YORK : DEPARTMENT OF HEALTH --------------------------------------------------------------------------X IN THE MATTER OF THE PREVENTION AND CONTROL OF EBOLA VIRUS DISEASE ORDER FOR SUMMARY
Tuberculosis What is tuberculosis? TB, or tuberculosis, is a disease caused by bacteria caused Mycobacterium tuberculosis. It is spread from person to person through the air. TB usually affects the lungs.
Roger Williams University Bloodborne Pathogens Exposure Control Plan Revised 12/2010 ROGER WILLIAMS UNIVERSITY BLOODBORNE PATHOGENS EXPOSURE CONTROL PLAN I. STATEMENT OF POLICY It is the policy of Roger
University of Tennessee Safety Program Program Subject: Lead Management Program Reviewed/Revised: 4/1/14 Areas Affected: All pre-1978 buildings on campus and other areas where lead is present Contact Information:
Tuberculosis Facts Below are frequently asked questions about TB, and their answers. Beginning on page 5 is specific information about TB at Longmont High School. If you have additional questions you may
Ambulance Service Patient Care and Transportation Standards Ministry of Health and Long-Term Care Emergency Health Services Branch Patient Care A. General Each operator and each emergency medical attendant
Safety & Health Program 10627 Midwest Industrial Boulevard, St. Louis, MO Phone: 314-785-6425 Fax: 314-785-6426 Sandblasting & Silica Exposure Control Plan The purpose of this program is to inform interested
Effective Date March 15, 2012 Page Page 1 of 8 FORMALDEHYDE EXPOSURE CONTROL PLAN, 29 CFR 1910.1048 The University of The District of Columbia Formaldehyde Exposure Control Plan is designed to inform employees
Subject Instructions for the screening of clients to detect tuberculosis (TB) in the context of the Canadian immigration medical examination (IME). Goal/Objective These instructions are provided to ensure
Chapter 5. INFECTION CONTROL IN THE HEALTHCARE SETTING INTRODUCTION This chapter addresses infection control measures and practices in the healthcare setting and provides guidance to healthcare facilities
Topics of Discussion Tuberculosis Emergency Department Diagnosis, Treatment, and Infection Control Elissa Schechter-Perkins MD, MPH, DTMH Assistant Professor of Emergency Medicine Boston university School
Course Guidelines Occupational Health and Safety for the Asbestos Worker February 2013 Table of Contents 1.0 Introduction...................................................... 1 2.0 Course Criteria...................................................
KEY CAL/OSHA STANDARDS THAT APPLY TO MOST EMPLOYERS FACTSHEET 1 Below are some key Cal/OSHA standards that apply to most employers: A. INJURY AND ILLNESS PREVENTION PROGRAM STANDARD (Title 8 California
HEALTH CARE GUIDELINES AND STANDARDS APPLICATION NOTE LC-126 INTRODUCTION This publication provides excerpts from some of the many guidelines and standards that pertain to the construction and operation
Nevada State Health Division Technical Bulletin Topic: Using QuantiFERON and Tuberculin Skin Test to Screen for TB Section/Program/Contact: Bureau of Community Health / Tuberculosis Program / Susanne Paulson,
New York University Tuberculosis Exposure Control Plan A. Purpose The purpose of this plan is to establish guidelines and policies for reducing the risk of transmission of TB to employees and volunteers
Biosafety in the Mycobacteriology Laboratory Thomas M. Shinnick, Ph.D. Mycobacteriology Laboratory Branch Division of Tuberculosis Elimination SAFER HEALTHIER PEOPLE Why is Biosafety Needed in the Mycobacteriology
12 Points of Tuberculosis (TB) Patient Education Transmission of TB TB is a disease caused by the TB germ. The disease is mainly in the lungs (pulmonary TB), but the germ can travel to other parts of the
Tuberculosis: FAQs What is TB disease? Tuberculosis (TB) is a disease caused by bacteria (germs) that are spread from person to person through the air. TB usually affects the lungs, but it can also affect
HUMAN RESOURCES DIVISION - EMPLOYEE HEALTH SERVICES MEDICAL AND TUBERCULOSIS CLEARANCE FOR NEW CERTIFICATED EMPLOYEES To ensure the attached forms are valid at the time of submission, do not proceed with
DIVISION of SUBSTANCE ABUSE SERVICES Tuberculosis Control Guidelines for Alcohol and Drug Abuse Treatment Programs 1. Purpose: This policy provides guidance and instruction to identify and prevent tuberculosis
HEATING, VENTILATION AND AIR-CONDITIONING SYSTEM (HVAC) Class 3 Facility: Local Anesthesia Heating, ventilation and air-conditioning system standards are a primary infection prevention and control strategy
Referral Guidelines for TB/HIV co-management (First Edition) Government of Lesotho April 2011 1 REFERRAL GUIDELINES FOR TB/HIV CO-MANAGEMENT INTRODUCTION Many TB patients are infected with HIV. Many people
HOFSTRA UNIVERSITY DEPARTMENT OF PHYSICIAN ASSISTANT STUDIES Medical clearance is mandatory in order to see any patient in the clinical setting. As there is patient contact in the didactic year, clearance
Interim Guidance for Medical Schools on health checks for active and latent Tuberculosis in medical students returning from elective periods overseas This document has been developed by: Dr Mathina Darmalingam
Name ofpolicy: Mandatory Tuberculosis (TB) Screening of Students from World Health Organization Designated High TB Prevalence Countries Policy Number: 3364-81-04-030 T()LED() Revision date: I 0/22/13 Approving
New Jersey Department of Health and Senior Services Public Employees Occupational Safety and Health Program Requirements for Preventing Occupational Exposure to Tuberculosis Background Revised November,
Occupational Hazards for Health Care Workers Photos from Occupational Safety and Health Administration, USA Who is a Health Care Worker? Nurse Doctor Aide, orderly Pharmacist Laundry worker Housekeeper
You can get more information about TB from the following: Local Public Health Nurse Community Clinic Nurse Communicable Disease Control Nurse Your Family or Community Doctor Your Infection Control Practitioner
TB & HIV co infection interactions, considerations, pitfalls Dr Sindisiwe van Zyl Background facing a double epidemic TB leads to HIV disease progression & vice versa 70% TB patients are HIV co infected
NOTICE IS HEREBY GIVEN that a public hearing will commence on Tuesday, September 23, 2008, at 9:00 a.m. (subject to continuance on that date of the hearing) at the Fresno County Board of Supervisors Chambers,
Interferon Gamma Release Assays (IGRAs) Lisa Y. Armitige, MD, PhD May 13, 2015 TB for Pulmonologist Phoenix, AZ March 13, 2015 EXCELLENCE EXPERTISE INNOVATION Lisa Y. Armitige, MD, PhD has the following
REPUBLIC OF NAMIBIA MINISTRY OF HEALTH AND SOCIAL SERVICES Tuberculosis Infection Control Guidelines i MINISTRY OF HEALTH AND SOCIAL SERVICES Tuberculosis Infection Control Guidelines Directorate: Special
Responsibilities of Public Health Departments to Control Tuberculosis Purpose: Tuberculosis (TB) is an airborne infectious disease that endangers communities. This document articulates the activities that
Virginia Commonwealth University Health System Medical College of Virginia Hospitals and Physicians Infection Control Policy Subject: Policy No: 1101.01 Original Date: Bloodborne Pathogen Exposure Control
Chapter 4 Section 4.06 Infection Prevention and Control at Long-term-care Homes Follow-up on VFM Section 3.06, 2009 Annual Report Background Long-term-care nursing homes and homes for the aged (now collectively
EAST CAROLINA UNIVERSITY INFECTION CONTROL POLICY Department: Adult and Pediatric HealthCare/ECU-Doctor s Park, Building #2 Date Originated: October 28, 1992 Date Reviewed: 10.28.92, 12.14.94, Date Approved: