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.
VIII. 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 determined by the Personnel Health Physician.
2. Interval TST screening as determined 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
B. Record keeping
I . Record keeping is critical for the long term needs of the employee, station, and
regulatory compliance
2. Record keeping to comply with VHA directives, manuals, and valid regulatory
agencies' requirements
C. Return to work clearance for health care workers with S/KI TB
1. At a minimum, retum to work clearance should follow current CDC guidelines
2. Employees must be monitored for lack of infectiousness
D. Healthcare Worker TST Conversions
The facility must track and eva'date TST conversions in order to document possible episodes of
transmission of tuberculosis in the healthcare setting, to define the facility risk assessment category and
to identify facility TST con.version rates.
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