According to the Centers for Disease Control and Prevention, a tuberculosis infection-control program should consist of administrative controls, environmental controls and a respiratory-protection program. Every setting in which services are provided to persons who have suspected or confirmed infectious TB disease, including laboratories and nontraditional facility-based settings, should have a TB infection-control plan.
The CDC recommends following these nine steps to establish a TB infection-control program in these settings.
1. Assign supervisory responsibility for the TB infection-control program to a designated person or group with expertise in LTBI and TB disease, infection control, occupational health, environmental controls and respiratory protection. Give the supervisor or supervisory body the support and authority to conduct a TB risk assessment, implement and enforce TB infection-control policies, and ensure recommended training and education of healthcare workers.
—Train the persons responsible for implementing and enforcing the TB infection-control program.
—Designate one person with a back-up as the TB resource person to whom questions and problems should be addressed, if supervisory responsibility is assigned to a committee.
2. Develop a written TB infection-control plan that outlines a protocol for the prompt recognition and initiation of airborne precautions of persons with suspected or confirmed TB disease, and update it annually.
3. Conduct a problem evaluation if a case of suspected or confirmed TB disease is not promptly recognized and appropriate airborne precautions not initiated, or if administrative, environmental or respiratory-protection controls fail.
4. Perform a contact investigation in collaboration with the local or state health department if healthcare-associated transmission of M. tuberculosis is suspected. Implement and monitor corrective action.
5. Collaborate with the local or state health department to develop administrative controls consisting of the risk assessment, the written TB infection-control plan, management of patients with suspected or confirmed TB disease, training and education of healthcare workers, screening and evaluation of healthcare workers, problem evaluation and coordination.
6. Implement and maintain environmental controls, including AII room(s).
7. Implement a respiratory-protection program.
8. Perform ongoing training and education of healthcare workers.
9. Create a plan for accepting patients who have suspected or confirmed TB disease if they are transferred from another setting.
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