3. * TB is caused by a bacterium called Mycobacterium Tuberculosis. The bacteria usually attacks the lungs, but TB bacteria can attack any part of the body such as the kidney, spine and brain. It not treated properly, TB disease can be fatal.

4. Purpose: * To provide guidelines to reduce the risk of occupational exposure to mycobacterium tuberculosis (TB) Policy: * Ambercare home health will minimize the occupational exposure to TB through the development of a TB exposure plan, personnel education and implementation

5. * Patients will be assessed on admission for high- risk categories or conditions, and signs and symptoms of TB * Close contact with someone who has infectious TB disease (20-30%) become infected with TB) * Foreign-bonurse persons * Low-income groups and homeless persons * Individuals who live/work in special settings * Health care workers who serve high-risk groups * Racial and ethnic minorities * Infants, children, adolescents * People who inject drugs

6. * The attending physician (or other authorized licensed independent practitioner) will be contacted for an order to perform a PPD skin test (with patient permission)

7. * TB is spread through the air from one person to another when a person with TB disease of the lungs or throat coughs, sneezes, speaks or sings. People nearby may breathe in TB bacteria and become infected (the bacteria can stay in the air for several hours, depending on the environment) * TB is NOT spread by: * Shaking hands * Sharing food or drink * Touching bed linens or toilet seats * Sharing toothbrushes * Kissing

8. * Persistent cough longer than 2 weeks * Bloody sputum * Night sweats * Weight loss * Anorexia * Fever

9. * A confirmed follow-up appointment with a licensed physician has been arranged * Sufficient medication has been given to the patient until the outpatient appointment * An nurse or RT is assigned to coordinate care/service

10. * Wear an N95 mask when entering home of patient with know or suspected TB * Please the patient on respiratory isolation only when there are children or immunocompromised individuals living in the home * Collect sputum for AFB in a well-ventilated area of home, away from other household members * Discontinue respiratory precautions when the patient has been on effective therapy, is improving clinically, and the sputum smear is negative for AFB on 3 consecutive days * Monitor patients with active TB for relapse with sputum smears every two weeks until discharged from care/services (if appropriate)

11. * All personnel will receive training/education UPON HIRE, AND ANNUALLY THEREAFTER. The education will include: * Basic concepts of TB transmission, pathogenesis, diagnosis, the difference between the signs and symptoms of latent and active TB * Potential for occupational exposure * Principles of infection control to reduce risk of transmission * Purpose of PPD skin testing * Principles of preventative therapy for latent infection * Principles of drug therapy and * Individual responsibility