N. HIV-related Issues
No specific heating, ventilation and air conditioning (HVAC) considerations are necessary for
patients with HIV infection.
O. Dialysis Program
A room which meets at a minimum current CDC ventilation and airfiow guidelines for S/KI TB must be
available for dialysis of S/KI TB patients. The location of this area is at the discretion of the facility.
Based on local need, this area may be in the dialysis unit or ICU, or other area in the Medical Center
based on patient need and efficient use of resources.
V. Respiratory Protection
A. General Criteria
Performance criteria for respiratory protective devices as outlined in the most recent CDC guidance are
to be met. This requires a respiratory protection program that follows the regulatory requirements of the
Occupational Safety and Health Administration (OSHA) as well as American National Standards Institute
(ANSI) Standards.
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 patients who have S/KI TB before deterrnination 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 Mycobacterium 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 epidemiology 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.
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