Box 2Set of measures for facility-level TB infection control a

The measures listed below are specific to health-care facilities. More details on congregate settings and households are given in Chapters 4 and 5, respectively.

Facility-level measures

7.

Implement the set of facility-level managerial activities:

  1. Identify and strengthen local coordinating bodies for TB infection control, and develop a facility plan (including human resources, and policies and procedures to ensure proper implementation of the controls listed below) for implementation.
  2. Rethink the use of available spaces and consider renovation of existing facilities or construction of new ones to optimize implementation of controls.
  3. Conduct on-site surveillance of TB disease among health workers and assess the facility.
  4. Address advocacy, communication and social mobilization (ACSM) for health workers, patients and visitors.
  5. Monitor and evaluate the set of TB infection control measures.
  6. Participate in research efforts.

Administrative controls b

8.

Promptly identify people with TB symptoms (triage), separate infectious patients, control the spread of pathogens (cough etiquette and respiratory hygiene) and minimize time spent in health-care facilities.

9.

Provide a package of prevention and care interventions for health workers, including HIV prevention, antiretroviral therapy and isoniazid preventive therapy (IPT) for HIV-positive health workers.

Environmental controls

10.

Use ventilation systems.

11.

Use ultraviolet germicidal irradiation (UVGI) fixtures, at least when adequate ventilation cannot be achieved.

Personal protective equipment

12.

Use particulate respirators.

a

Note: measures 1–6 are given in Box 1, in Chapter 2.

b

The administrative controls include (in addition to the items listed above) reduction of diagnostic delays, use of rapid diagnostic tests, reduction of turnaround time for sputum testing and culture, and prompt initiation of treatment. These are discussed in the text below.

From: 3, Reducing transmission of TB in health-care facilities

Cover of WHO Policy on TB Infection Control in Health-Care Facilities, Congregate Settings and Households
WHO Policy on TB Infection Control in Health-Care Facilities, Congregate Settings and Households.
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