Page 152 - policy and procedure infection control

Policies and Procedures on Infection Control

7. TUBERCULOSIS

7.1 Introduction
The risk of TB transmission between patients to health care workers (HCW) and vice versa
in a health-care setting is real. There is recent increase in the incidence of tuberculosis
(TB) among health care workers documented. The need to have a good, effective and
updated policy on infection control for tuberculosis in health care setting is urgent.

The risk of TB transmission from one person to the other depends on the infectiousness of
patient, duration of exposure and environmental conditions.. The chain of transmission
can be reduced by isolating patient with active disease, starting effective anti-tuberculosis
treatment and taking appropriate control measures. Infection control policies for special
healthcare settings are developed and reviewed regularly.

7.2 Hierarchy of TB infection Control
7.2.1 Administrative controls (managerial)
The most important measures of TB infection control is to prevent exposure and
reduce transmission to health care workers and patient.
1. Written TB Infection Control Plan.
2. Workplace Risk Assessment
3. Triage and screening of patients
4. Early diagnosis, prompt treatment and isolation
5. Training and education of health care workers
6. Patient education e.g. cough hygiene

7.2.2 Environmental control
Prevent the spread and reduce the concentration of infectious droplet in the air.
Type of environmental control includes:
1. Maximizing natural ventilation through open and free flow ambient air with
open windows

2. More complex methods
• Ventilation system e.g. local exhaust ventilation (LEV).
• Negative pressure rooms or airborne infection isolation (AII) room.
• High Efficiency Particulate Air (HEPA) filtration to remove infectious
particles.
• Ultraviolet germicidal irradiation (UVGI) to sterilize the air.

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