Disseminated TB and exposure risk

[TigerGalLE, BSN, RN]

So before I transferred from my med-surg floor to the ICU I took care of a young lady that was very ill with a septic hip and meningitis. They did not place her on droplet precautions because even though it appeared to be bacterial meningitis it was not meningococcal meningitis. I took care of this patient for 3 12 hr shift without any expanded precautions. I then transferred to the ICU and never found out what happened with this particular patient's case.

So I heard through the grapevine that the patient apparently was found to have disseminated TB. So I had my annual N-95 mask fitting today and I spoke with the employee health nurse about my exposure risk. She wasn't sure how contagious disseminated TB was but encouraged me to get a PPD placed to be safe. I then went and talked to the supervisor of my old unit. She said they called the CDC about the exposure risk to the staff and they said no one needed to be tested since the patient did not have an active respiratory infection. I asked the supervisor how they found out the patient had disseminated TB and she said the patient had a bronchoscopy and it grew out in her bronchial washings. To me that means that it could be spread via the airborne route. No one on the unit has had a PPD placed.

I went from speaking to my supervisor to my employee health office to have a PPD. I'd rather be safe than sorry.

So what do you guys think?

Edit: Once they knew she was positive for TB they placed her on airborne precautions.

Tiger

[nursesaurus]

It is better to be safe than sorry. Kudos to you!

[AnaCatRN]

I agree! You need to know. I hope all is well! I really hate how they try to minimize their potential responsibility by sweeping this stuff under the rug. It always takes forever for them to find out a pt has TB, then they rush to put them on precautions and act like all those shifts we worked prior couldn't possibly put us at risk. Yeah, right. Then why put them on precautions at all? Argh!

[Straydandelion]

This is confusing because the CDC site doesn't specify "respiratory infection" as far as whether to test or not.

CDC | TB | Tuberculosis Fact Series - Exposure to TB

[aura_of_laura]

Employees are required to have a TB test annually, with some people being done each quarter. I'm not sure what the point of rushing out to do a PPD would be - I'm pretty sure it's not going to show something right after the exposure. Plus, it sounds like it was only a tentative exposure, not confirmed. "Hearing through the grapevine" sounds like not only a HIPAA violation, but a waste of time. If the CDC and the hospital says the patient did not have an active respiratory infection, sounds like you're worried over nothing.

[TigerGalLE, BSN, RN]

We no longer do annual PPDs because I live in a "low risk area." Actually, my old charge nurse told me the patient's TB came back positive in her bronchial washings. I don't think it is a HIPPA violation if it affects my safety as a health care provider. Maybe I'm wrong on that part though..... ??