Infection Prevention Manual

EXPOSURE CONTROL PLAN POLICIES FOR CARE OF PATIENTS WITH SUSPECTED TB INFECTIONS 1. Home care for patients with suspected TB infections shall provide for early identification of active TB. Symptoms include, but are not limited to the following: a. productive cough, b. coughing up blood, c. weight loss, d. loss of appetite, e. lethargy, f. weakness, g. night sweats h. fever 2. Care of patients with suspected or confirmed infections shall be available and shall include: a. precautions to prevent exposure until communicability has been eliminated by chemotherapy b. instructing patients to cover coughs and sneezes c. instructing patients who are on TB medications about the importance of taking medications as prescribed unless adverse effects are seen 3. Individuals with suspected or confirmed TB should, to the extent possible, be isolated from other residents in an area with the maximum possible ventilation as follows: a. In a facility other than the home, regulations require isolation of patients in an acid fast bacilli (AFB) isolation room and, in areas where high hazard procedures are performed on such individuals, negative pressure and appropriate means to release exhaust must be maintained. b. Since this is not possible in the home, use of an approved particulate respirator is appropriate. c. A warning sign should be posted outside of the patient's room e.g. "Special Respiratory Isolation" or "AFB Isolation" or a description of the necessary precautions. 4. The agency shall make provisions for the performance of and instructions regarding cleaning, disinfecting or sterilizing as follows: a. Generally, critical items should be sterilized (needles, instruments or items introduced into the bloodstream or sterile areas of the body), b. semi-critical items should be sterilized or cleaned with high-level disinfectants (non-invasive flexible items such as endoscopes or bronchoscopes), c. non-critical items should be cleaned with detergents or low-level disinfectants (crutches, bedboards, blood pressure cuffs etc). Selection of chemical disinfectants depends on the intended use, level of disinfection required, and the structure and material of the item to be disinfected.