15 Miss. Code. R. 16-1-47.11.7 - Employee Testing for Tuberculosis
1. Each employee,
upon employment by a licensed entity and prior to contact with any resident,
shall be evaluated for tuberculosis by one (1) of the following methods:
A. IGRA (blood test) and an evaluation of the
employee for signs and symptoms of TB by a licensed physician, physician's
assistant, nurse practitioner, or registered nurse; or
B. A two-step TST administered and read by
certified personnel and an evaluation of the employee for signs and symptoms of
TB by a licensed physician, physician's assistant, nurse practitioner, or
registered nurse.
2. The
IGRA/Mantoux testing and the evaluation of signs and symptoms may be
administered on the date of hire, or administered/read no more than 30 days
prior to the employee's date of hire; however, the employee must not be allowed
contact with a resident, or work in areas of the facility where residents have
access until receipt of the results of the IGRA/assessment or at least the
first of the two-step TST has been administered/read and assessment for signs
and symptoms completed.
3. If the
TST is administered, results must be documented in millimeters. Documentation
of the IGRA/TST results and assessment must be documented in accordance with
accepted standards of medical/nursing practice and must be placed in the
employee's personnel file no later than seven (7) days of the employee's date
of employment. If an IGRA is performed, results and quantitative values must be
documented.
4. Any employee noted
to have a newly positive IGRA, a newly positive TST, or signs and symptoms
indicative of TB that last longer than three (3) weeks (regardless of the size
of the TST or results of the IGRA), shall have a chest x-ray and be evaluated
for active TB by a licensed physician within 72 hours. The employee shall not
be allowed to work in any area where residents have routine access until
evaluated by a licensed physician, physician's assistant, or nurse practitioner
and approved to return to work. Exceptions to this requirement may be made if
the employee is asymptomatic; and
A. The
employee is currently receiving or can provide documentation of having received
a course of TB prophylactic therapy approved by the MSDH TB Program;
or
B. The employee is currently
receiving or can provide documentation of having received a course of
multi-drug chemotherapy approved by the MSDH TB Program; or
C. The employee has a documented previous
significant TST reaction or IGRA reaction.
5. For employees noted to have a previous
positive to either a TST or the IGRA, annual re-evaluation for the signs and
symptoms must be conducted and must be maintained as part of the employee's
annual health screening. A follow-up annual chest x-ray is NOT required unless
symptoms of active TB develop.
6.
If using the Mantoux method, employees with a negative TST and a negative signs
and symptoms assessment shall have the second step of the two-step TST
performed and documented in the employee's personnel record within 14 days of
employment.
7. The IGRA or the
two-step protocol is to be used for each employee who has not been previously
skin tested and/or for whom a negative test cannot be documented within the
past 12 months. If the employer has documentation that the employee has had a
negative TST within the past 12 months, a single test performed 30 days prior
to employment or immediately upon hire will fulfill the two-step requirements.
As above, the employee shall not have contact with residents or be allowed to
work in areas of the facility to which residents have routine access prior to
reading the skin test, completing a signs and symptoms assessment, and
documenting the results and findings.
8. Facilities shall comply with
recommendations from the Centers for Disease Control and/or the MSDH regarding
baseline employee TB testing and annual employee TB education. Employees
exposed to an active infectious case of TB shall be treated as contacts and be
managed appropriately. Employees found to have a significant TST reaction and a
chest x-ray not suggestive of active TB, shall be evaluated by a licensed
physician, physician's assistant, or nurse practitioner for treatment of latent
tuberculin infection.
9. All
employees should receive TB education annually. TB education should include
information on TB risk factors, signs and symptoms of TB disease, and TB
infection control policies and procedures.
10. The facility should keep documentation of
such education and update annually.
Notes
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No prior version found.