Tuberculosis

Tallahassee Memorial Healthcare

Tuberculosis
The Centers for Disease Control and Prevention (CDC) and the Occupational Safety and Health Administration have determined that all healthcare workers should be educated about Tuberculosis (TB) in order to increase awareness and prevent transmission of the disease.

Training
Colleagues should be trained at the time of hire and review the information annually. In order to meet these recommendations, please read the information.

Policy
A copy is the TMH Tuberculosis Exposure Control is available in the Infection Control book located on the Intranet under Infection Control/Employee Health Services. Please review the information in the plan thoroughly in order to familiarize yourself with your role in the prevention of transmission of tuberculosis.

Transmission
TB is spread from person to person through the air. When a person with infectious TB disease (TB that can be spread) coughs or sneezes, tiny particles containing M. tuberculosis may be expelled into the air. These particles, called droplet nuclei, are about 1 to 5 microns in diameter less than 1/5000 of an inch. Droplet nuclei can remain suspended in the air for several hours, depending on the environment.

Signs & Symptoms of Active TB Infection

Cough for greater than 3 weeks Weight loss Coughing up blood Fever and/or night sweats Anorexia
Patients with the above symptoms and/or patients who have orders for sputum for AFB must be started on Airborne Isolation immediately. (Patient should wear surgical mask until placed in an isolation room with negative air pressure.

Proper Isolation
For suspected or confirmed tuberculosis the proper isolation is Airborne Isolation in a private room (Example of Airborne Isolation Sign with Instructions - sign has white lettering on a red background)
AIRBORNE ISOLATION STOP
> Respirator mask...to enter room > Keep door closednegative air pressure room > Transport.limit to essential purposes. Mask patient with surgical mask for transport & notify receiving department > Standard Precaution.for all other aspects of patient care *Continue these precautions for 1.5 hours after patient is discharge from room

STOP

Screening
TMH colleagues are required to have annual screening via PPD or questionnaire. Colleagues must be fit-tested to assure proper fit of N-95 mask.

Positive Skin Test

Diagnosis of TB Infection: The Tuberculin Skin Test
The tuberculin skin test is used to determine whether a person has TB infection. In this test, a substance called tuberculin is injected into the skin. Tuberculin is protein derived from tubercle bacilli that have been killed by heating. In most people who have TB infection, the immune system will recognize the tuberculin because it is similar to the tubercle bacilli that caused infection. This will cause a reaction to the tuberculin. Tuberculin is used for diagnosing TB infection; it is not a vaccine. A positive skin test (PPD) does not mean the employee can not work. Infection Control and Occupational Health will work with the colleague.

Isolation Orders
A physicians order is not required to start Airborne Isolation. Consult Infection Control prior to discontinuing Airborne Isolation.

Treatment
Tuberculosis can be treated. Treating TB infection/disease benefits both the person who has TB and the community. It helps the patient because it prevents disability and death and restores health; it benefits the community because it prevents the further transmission of TB.