B. Respiratory Protective Devices
Respiratory protection is required for persons entering rooms in which patients with S/KI TB are being
housed, for persons present during cough-inducing, aerosol-generating procedures performed on such
patients, and for persons in other settings where administrative and engineering controls are not likely to
protect them from inhaling, infectious airborne droplet nuclei. These other settings include transporting
patients who may have S/KI TB in emergency transport vehicles, and providing urgent surgical or dental
care to pa6ents who have S/KI TB before determination has been made that the patient is non-infectious.
These settings may also include home based health care programs, where patients with S/KI TB are being
seen in the home setting.
In the Mycobacteriology Laboratory, routine use of respiratory protective devices should not be
necessary. However, if the laboratorian is working with significantly amplified Mycobacteriurn
tuberculosis cultures in liquid media, or performing specific procedures where aerosolization is expected,
the use of respiratory protective equipment, gloves and gowns may be appropriate. The most recent
standards for laboratory practices should be followed.
VI. Healthcare Worker Training
All health care workers are to receive periodic TB education appropriate for their work responsibilities
and duties and should include epiderniology of TB in the facility, mode of transmission, pathogenesis,
diagnosis, and occupational risk for tuberculosis. The training should also describe work practices that
reduce the likelihood of transmitting Mycobacterium tuberculosis in the healthcare setting. The training
must be given to all those who work at the VA Medical Center who are at risk for the transmission of
tuberculosis. All training is to follow the latest written regulatory requirements of valid oversight bodies
such as OSHA.
VII. Healthcare Worker Counseling And Screening
All healthcare workers should be counseled regarding tuberculosis disease and tuberculosis infection.
This should include information about the increased risk to immunocompromised persons for developing
active tuberculosis disease.
VIU. Personnel Health
A. TB Screening using most current CDC methodology
1. Prior to employment, TST results are required for covered employees who work in the
VHA- For any TST done outside the Personnel Health Unit on station, appropriate written documentation
must be provided as detained by the Personnel Health Physician.
2. Interval TST screening as detained by risk assessment as outlined in the most recent CDC
guidance should be conducted.
3. TST is recommended at the time of separation for all employees
4. Follow all pertinent VACO Directives and Manual references related to TB screening
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