Purpose:

To screen all Students for Tuberculosis in order to ensure their safety and control cross infection of students and staff on campus, as recommended by the Centers for Disease Control.

Applies to:

ALL Hillcrest Educational Centers, Inc., Students and Employees.
Components:

1. Routine T.B. Screening
a. ALL new employees, except those known to be skin test positive, shall be given a skin test by Occupational Health using 5 t.u. (.1 ml) of

PPD.
b. ALL students are required to present documentation of PPD screening within 60 days of admission. For past positive reactors, a chest X-ray or TB Clinic Report, prior to acceptance, is required in lieu of testing. Such situations will be reviewed by the medical director on admission and follow up will be done as ordered.
d. ALL students in residence will be given a TB screening every year and a TB test planted if indicated. Positive reactors who have completed adequate preventative treatment do not need repeat chest films, unless they have pulmonary symptoms, which may be due to TB.

2. Testing After Potential Exposure:
a. Immediately following significant exposure to an employee, or student having suspected tuberculosis, all PPD negative persons at risk, will be skin tested. If the test is negative, it will be repeated 12-weeks after exposure, in accordance with CDC Guidelines.
b. Positive reactors do not require a skin test or chest film following exposure, unless they have symptoms suggestive to Tuberculosis.

3. Follow-Up:
a. Employees or Students with a positive skin test, will be required to have a chest X-ray. Those who convert from negative to positive, or have suspicious chest X-rays, will be referred to the Tuberculosis Clinic, or to a private Physician.

4. PPD Skin Test Interpretation
a positive skin test will be defined as follows:
a. 10 mm. induration is considered positive in:
1) Persons having recent close contact with an individual with active T.B.

2) Individuals with a chest X-ray and History consistent with, prior untreated T.B.
b. 15 mm. induration will be considered positive for ALL others.

5. Responsibilities of the Nursing Department
a. Administer TB screenings and TB skin tests if indicated, refer for follow-up, as indicated.
b. Keep appropriate records of each Student.
c. With post-exposure TB testing:

1. Notify exposed personnel, and arrange for skin tests. It is the responsibility of the exposed person to be tested within 5 days of notification.

2. ANY exposed person, who does not have documentation of negative results, cannot return to work, as recommended by the CDC.

3. Notify ALL exposed Personnel and arrange for skin tests to be repeated in 12 weeks.

4. Refer ALL appropriate personnel to a private physician or the Tuberculosis Clinic.

5. Inform the positive (PPD or chest X-ray) personnel to return to work with documented proof of follow-up care, prior to returning to work, as per CDC Guidelines.
d. Notify the Board of Health in accordance with MGL C71, S555A.
e. NO facilities for isolation are available at Hillcrest Educational Centers. If a student who is previously negative is found to have active TB, IMMEDIATE transfer to a health care facility where isolation is available must be arranged.