Infection Prevention Manual

EXPOSURE CONTROL PLAN POLICIES FOR CARE OF STAFF WITH SUSPECTED TB INFECTIONS 1. The agency shall manage staff with newly recognized conversions or a positive Mantoux PPD, and staff diagnosed with active TB. A. Agency staff who convert or who test positive on the Mantoux PPD test shall: (1) be requested to obtain a chest x-ray to determine if clinically active TB is present. (2) if symptomatic, the staff will be excluded from work until a physician's written statement of non-infectious status is obtained. B. When the agency has staff with newly recognized conversions or a positive Mantoux PPD: (1) The positive Mantoux PPD, medical evaluation and treatment will be documented on the staff member's employee medical record. (2) The agency will report the positive Mantoux PPD to the local health department. (3) The agency shall attempt, in coordination with the local health department, to identify the source of the exposure. (4) If the source of exposure is work related the agency will post the exposure on the OSHA 200 log. C. When agency staff are diagnosed as having active TB the agency shall: (1) exclude the staff member from work until a written statement of non-infectious status from the physician and the staff member has been shown to have three (3) consecutive daily AFB smears that are negative: (2) when the staff member returns to work, require documentation from the staff member's health care provider that he/she is maintained on effective therapy and remains AFB sputum smear negative: (3) if the staff member discontinues therapy before the course has been completed, they must be excluded from work. Staff members with active TB sites other than the lung or the larynx usually do not need to be excluded from work. 2. The agency shall provide training and education of staff. A. Agency staff will receive training and education in TB infection control and the use of respiratory protection on hire and annually. B. The staff training and education will include: (1) The basic concepts of TB transmission, pathogenesis, and diagnosis. (2) The potential for occupational exposure to persons with infectious TB. (3) The principles and practices of infection control that reduce the risk of TB transmission. (4) The purpose of Mantoux PPD testing and the importance of the skin test program. (5) The principles of preventive therapy for latent TB infection. (6) The responsibility of the staff member to seek medical evaluation promptly if symptoms of TB develop or if the Mantoux PPD tests converts to positive. (7) The principles of drug therapy for active TB. (8) The importance of notifying the agency if diagnosed with active TB. (9) The responsibilities of the agency to maintain the confidentiality of the staff member who converts or develops active TB. (10) The higher risk posed by TB to the immune compromised individual or those with HIV. (11) Education specific to home care: a. Cough producing procedures performed on patients with infectious TB should not done in the home unless absolutely necessary. b. Such procedures should be done in a health-care facility in a room or booth with the recommended ventilation for such procedures. c. If these procedures must be done in a patient's home, they should be performed in a will-ventilated area away from other household member. d. If feasible, the home care staff should consider opening a window to improve