Page 153 - policy and procedure infection control

Policies and Procedures on Infection Control

7.2.3. Personel protective equipment (PPE)
The use of appropriate PPE is important and HCW must be trained to use PPE
correctly.

7.2.4 Screening for HCW
Health care workers should be screened for Tuberculosis whenever they are
symptomatic. Chest radiograph and Tuberculin Skin Test are not routinely
recommended.

7.3 Infection control in specific area
7.3.1 Inpatient setting
1. All patients with infectious or potentially infectious Tuberculosis should be
placed in(Airborne Infection Isolation /Negative Pressure) AII room if pos-
sible. However, if AII room is not available, TB patients should be cohorted
from non tuberculosis patient, infectious from non infectious TB patients.

2. Isolation ward or area for TB patients should have maximum natural venti-
lation, mechanical ventilation by local exaust ventilation and air cleaning
methods such as HEPA filter and/or Ultraviolet Germicidal Irradiation (UVGI)
whenever appropriate.
3. All patients suspected or confirm TB should be educated about the impor-
tance of cough etiquette (refer to std precaution) and wear surgical or close
the mouth/nose when sneezing or coughing
4. All health care workers handling infectious TB patients should use PPE
properly, ideally at least N95 mask. HCW handling non infectious or un-
confirmed cases should use N95 whenever possible.
5. Only minimum number of visitors should be allowed to visit active TB pa-
tient in the Ward. Protections for visitor are similar to medical staff.

7.3.2 Sputum induction area/room
1. Sputum induction should be performed in an area or room with local ex-
haust ventilation (e.g., booths with special ventilation) or alternatively in a
room that meets the requirements of an AII room.

2. N95 disposable respirator should be worn by HCWs performing sputum
inductions on a patient with suspected or confirmed infectious TB disease.
3. After sputum induction is performed, allow adequate time before perform-
ing another procedure in the same room.
4. Patients with suspected or confirmed infectious TB should wear surgical
mask after the procedure.
7.3.3 Outpatient and emergency department
1. Triage. Triaging patient at the counter should be done to identify high risk
patients by history taking (patient with history of cough for more than 2
weeks). Specific waiting area or room for patients are recommended.

142 Ministry of Health Malaysia