First Draft 4-15-97
Narrative
Primer Package - Tuberculosis
The U.S. Department of Health and
During this decade the issue of
Human Services, Public Health Service
Tuberculosis
has
again
gained
Centers for Disease Control and
prominence in both medical literature and
Prevention (CDC) has also in its Morbidity
the national press as a major threat to life
and Mortality Weekly Recommendations
and health. The numbers of active cases
and Reports issued a Guidelines for
have increased nationwide, particularly
Preventing
the
Transmission
of
along the coastal areas of the United
Mycobacterium
Tuberculosis
in
States
where
there
are
dense
Healthcare Facilities, dated Oct. 28, 1994.
populations, but no area has been
Vol. 43, No. RR-13 This report is too
spared, and sporadic cases have been
large to include in this Primer but contains
reported in all VA regions.
much useful reference material.
The
Report covers many of the items
The U.S. Department of Health and
mentioned in the VA Program and Facility
Human Services Public Health Service
Planning Guidance Report but has more
Centers for Disease Control and
detail on the many aspects of TB. The
Prevention (CDC) and VA's TB Guidelines
are
major
controls
for
current
CDC
Report
contains
several
recommendations to be followed by VA
recommendations for isolation rooms:
Facilities. (Enclosure 1 of this Design
1. An Ante Room may increase the
Guide.)The VA's Program & Facility
effectiveness of the isolation room by
Planning Guidance for Tuberculosis
minimizing the potential escape of droplet
Programs of August 18, 1995 defines
nuclei into the corridor when the bedroom
characteristics of TB Programs by
door is open.
discussing
Responsibility,
Risk
Assessment Characteristics, TB Plans,
should be considered whenever exhaust
Periodic Reassessment Identification,
air could possibly re-enter the exhaust
Evaluation and treatment of TB Patients,
system. According to CDC, a regularly
Engineering Controls, Healthcare Worker
scheduled maintenance and monitoring
Training, Counseling & Screening and
program is required for HEPA filters. A
Personnel Health.
There is also a
dioctal phthalate (DOP) penetration test
bibliography of contemporary relevant
should be performed at the initial
sources. This document has been added
installation and every time the filter is
to the HVAC Design Manual for Hospital
changed or moved. The test should be
Projects as item A36 "TB Criteria" and
repeated every six months.
should apply to all future VA Projects.
3. Emergency Power the medical center
VA Standards Service (I87C) has recently
could consider emergency power for fans
completed a Technical Summary titled
if it is determined to be practical.
HVAC Requirements in TB Isolation
These items are recommended, but not
Room Suite which defines mechanical
mandatory and can be precluded by
requirements for this most important
budgetary restraints
.
room. See Enclosure 2 and Guide Plates
3-1 and 3-2 provided in this document.
VA DESIGN GUIDE
TUBERCULOSIS PRIMER
PAGE 2-1
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