Potential high risk employees include emergency department personnel, respiratory therapists, microbiology laboratory workers, and pathologists, specialists in pulmonary medicine and nurses in some settings (McGowan, 1983; CDCP 1995).
It is imperative to control TB and for this every health-care setting should have a TB infection-control plan. It is crucial because it depends on whether patients with assumed or established TB disease might come across in the setting or whether patients with suspected or confirmed TB disease will be transferred to another health-care setting.
The TB infection-control program must encompass administrative controls, environmental controls, and a respiratory-protection program. These are the important control parameters as every location in which services are offered to individuals who have suspected or confirmed infectious TB disease, counting the hospital settings, should have a TB infection-control plan. The following methods must be adopted for TB infection-control program in HCWs settings:
These are the important control parameters as every location in which services are offered to individuals who have suspected or confirmed infectious TB disease, counting the hospital settings, should have a TB infection-control plan. The following methods must be adopted for TB infection-control program in HCWs settings:
1. Supervisory responsibility is essential for the TB infection-control program and this should be given to the authorized person deputed for the same. The supervisor must be supported to carry out the risk assessment for tuberculosis. HCWs must be educated to take the required training and ensure their actions in the direction of disease control.
2. Proper training is required to perform and enforce the TB infection-control program.
3. Atleast one person be designated to whom the problems must be addressed.
4. A protocol must be developed to get a TB infection-control plan and must be updated annually.
5. The problem must be evaluated and prompt recognition be made.
6. A contact investigation must be made in co-ordination with the local or state health department.
7. Implement and maintain environmental controls, including airborne infection isolation (AII) room(s) (see Supplement, "Environmental Controls" in the original guideline document).
8. Respiratory-protection program must be applied.
9. Constant training programme must be done to keep the HCWs updated and well-informed.
It is very imperative to understand the implications of TB and therefore considering the repercussions of the infection, PPD skin test is arranged on a routine basis. It is the prime responsibility to the HCWs to keep a check of their records when to undergo PPD skin test. The best method to remember this is through the