Tuberculin Management Program

Introduction

Date of Last Review 3/16/10

Date of Last Review 10/18/10

Date of Last Review 10/31/11
SME: Infection Control Manager

UTHCPC screens employees, trainees, and volunteers for evidence of turberculin infection or disease.

Reason: To prevent the spread of infection between patients and staff.

PPD Requirement

All UTHCPC employees must comply with the mandatory PPD skin test requirement upon employment and annually thereafter.

Including: In addition to testing all employees covered in the CDC definition of employee, UTHCPC also tests all other direct and indirect care providers.
Examples: Contract employees, Pharmacy, Food & Nutrition, Research

Pregnancy

The PPD skin test is not contraindicated for pregnant employees.

PPD testing process

This table describes the PPD skin testing process:

Stage	Description
1	The UT Employee Health Clinic uses this table to determine whether or not to test the employee upon hire: WHEN the employee... THEN... Does not have proof of previous testing The UT Employee Health Clinic administers a PPD skin test. Has proof of testing within the past 6 months from outside the UTHCPC/UT Health Clinic System The employee provides documentation to the Infection Control Nurse and/or the UT Health Clinic. The process continues with Stage 7.
2	The Infection Control Practitioner or designee reads the skin test 48 to 72 hours after administration of the test.
3	The Infection Control Practitioner or designee notifies the UT Health Clinic of test results.
4	The employee uses this table to determine what happens next: WHEN the test results are... THEN the employee... Negative (If a new hire) repeats the skin test in 2 weeks-1 month. Takes the test annually in the month of her/his last test date. Note: No more than 12 months passes without TB testing. Positive Reports to the UT Employee Health Clinic for evaluation and clearance before returning to work. Note: For treatment, the employee is referred to her/his primary care provider.
5	If the employee chooses to go to her/his private healthcare provider, s/he provides documentation of CXR results to the following within 48- to 72-hours of the PPD reading: UT Employee Health Clinic UTHCPC Infection Control Practitioner or designee
6	The Infection Control Practitioner files a copy of the employee's baseline CXR in the employee's health file.
7	The employee uses this table to determine what happens next: WHEN the employee... THEN s/he... Is asymptomatic Signs a waiver each year stating that s/he is asymptomatic Note: Employees with a positive skin test should not undergo skin testing each year. Has symptoms of TB and/or initiates medicines prophylactically Notifies the Employee Health Clinic and Infection Control Practitioner or designee

Post-BCG vaccine process

This table describes what an employee should do if s/he has previously received the BCG vaccine, but has never had a positive TB skin test:

Exposure to TB

This table describes what an employee must do when s/he is exposed to TB:

Reporting

The Infection Control Practitioner reports conversion/compliance rates and actions to the Infection Control Committee.

Failure to comply

Failure to comply with testing and/or documentation requirements within the designated timeframe results in suspension without pay and may lead to further disciplinary action, including termination.

Related standards

The Joint Commission : Surveillance, Prevention, and Control of Infection

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