MRhodes

Try Infection Control --- now that current and former ICP's quit laughing - it/s a 24 hour job contained in 5 days weekends and holiday off - but in the almost 15 years in IC, I was only called in a few times. I can say doc and surgeons won't yell at you - EVERYONE will. But you do make a difference. Prevent one infection, save a person from a needlestick and your day is made. It's not just a job, it a life! Think on it. Chalanging yet rewarding. 1. I don't have to be on call 2. I don't have to work nights 3. I will have regular day shift hours 4. I will get Sat and Sun off 5. I don't have to take care of 7 patients and break my back 6. I don't have to stay 2 hours extra everyday to chart 7. I will feel that I have acomplish something at the end of the day 8. I will not be yelled at by some doctors or surgeons I feel like I am in the wrong field. What should I do? Do you feel the same as I do? I am depress most of the time and I drag my feet to go to work. I want to call in sick all the time.

as long as the afb in the sputum are "dead", respiratory precautions should not be necessary. however an n95 should be used for wound care, especially irrigation. melba

Check your state sanitary code. It will probally say that retractable sharps go in the sharps container and I believe that OSHA says so too. That will give you some "teeth" to tell the agency nurses it's your policy. You should also check and see what handbook the nurses are getting when they sign in and make sure it has some infection control measures in it. You could put that retractable sharps go in the sharps container in there, then if they do put them in the trash, you've got them for not following policies. Melba Rhodes [email protected]

Check your state sanitary code. It will probally say that retractable sharps go in the sharps container and I believe that OSHA says so too. That will give you some "teeth" to tell the agency nurses it's your policy. You should also check and see what handbook the nurses are getting when they sign in and make sure it has some infection control measures in it. You could put that retractable sharps go in the sharps container in there, then if they do put them in the trash, you've got them for not following policies. Melba Rhodes [email protected]

You need to go by cultures, but since it takes 6 to 8 weeks to get the cx back you must go by improving symptoms, improving CXR and on therapy for over 2 weeks. The only thing about HIV infected persons is thier immune system is caflooy. So they may not show the same symptoms. If you can get a quick TB test on the cx you can tell more about it (a gen probe or mtd). If this is neg the pt is not infectious.

You need to go by cultures, but since it takes 6 to 8 weeks to get the cx back you must go by improving symptoms, improving CXR and on therapy for over 2 weeks. The only thing about HIV infected persons is thier immune system is caflooy. So they may not show the same symptoms. If you can get a quick TB test on the cx you can tell more about it (a gen probe or mtd). If this is neg the pt is not infectious.

You are right. Contact precautions includes gloves and handwahsing. I understand the double shifs. Been there, done that. Our job is to impress upon all nurse that no matter how tired the are, they still need to follow precautions. I did this by e-mal, fax, walk-around inservices, posters in the employee restrooms as well as traditional inservices. We need to use every method at our disposal to stop SARS in it's tracks. Melba

Forgot to say our nurses use a N95 for flu like symptoms and have been fit tested (for TB). I do agree most cases were missed. We have enough N95s mainly because we have a lot of TB cases. Melba

I hope we don't have outbreaks too. BUt if we'd follow our own Standard Precautions rules we would wear a mask when withing three feet of persons with symptoms of the flu or SARS. Melba

Remember the flu is transmitted by droplets, so the HCW should wear a surgical mask when within 3 feet of the infectious person. Also teach the patient to cover thier mouth and nose when they sneeze or cough.

Couldn't post entire file. Please send e-mail address for entire file. Got flu shot acceptance up to 50% using these ideas. [email protected] Flu Vaccine and Infection Control Open House Themes It's almost that time of year again. Flu vaccination time and Infection Control Week! Want to boost your rates and provide information at the same time? Put a little zing into your function? Below are listed some tried and true flu vaccination programs. Combine with your Flu Vaccine push with or as part of your Annual Open House or Infection Control Week celebration. An Infection Control/Employee Health Open House held in October provides a forum to promote effective measures to prevent or control the spread of infection and to raise awareness of the essential services provided by infection control and employee health and an opportunity to let the staff know what infection control and employee health do all year. Use the theme on your memos and flyers and to decorate the booth. The first step is to plan, plan, plan. Plan ahead for several years - this allows you to buy ahead and save. Infection Control. Go for the Gold: - Refreshments: Serve lemonade and yellow cookies (a sugar cookie recipe and add yellow food coloring) shaped in sports shapes. - Activities: Focus on the Infection Control Program. Hand out lapel ribbons (knot these color of thin ribbons together and pin them on, hand out the "legend"). Gold stands for Asepsis, Green stands for Handwashing, Purple stands for Standard Precautions, Yellow stands for Employee Health and Red stands for Isolation. Hand out blue ribbons for the cleanest unit or department. - Door Prize:As the door prize give away a year's seasons tickets to a local football team (try and get this donated) or a fitness basket (jump rope, weights, sweatband etc.). - Theme: Use a sports theme. Good for an Olympics year. - Displays: - Using the sports theme, use a goal post and post the IC programs surveillance goals and where you are in reaching these goals. - Packets: Go for the Gold packets containing gold coins and chocolate footballs, "flu fact" prevention tips, tissues, and a post-vaccination survey and VIS in a ziplock bag.

The ABCs of Infection Control By Melba Rhodes, RN, BSN Practicing aseptic technique, good body hygiene and developing a caring attitude comprise the ABCs of infection control. In this article, we will discuss the three major components of Asepsis -- handwashing, disinfection and sterilization -- Body Hygiene -- personal hygiene and dress code -- and a Caring Attitude -- a good sense of right and wrong essential to the practice of the ABCs of infection control. The ABCs of infection control are fundamental in preventing adverse events. Infectious diseases may become a major health hazard to healthcare workers and patients. Knowing the hazards and following established guidelines and policies can reduce your and the patient's risk of transmission of infection. Safety guidelines are established for a reason -- to protect you, the employee and the patient. Even though at times some policies may seem to take too much time, if you consider the risks of not following these guidelines, you will realize the importance of the measures to help protect you and provide a safe and healthy workplace. A person entering the hospital or clinic with an infectious disease, such as AIDS or hepatitis B, does not always have this condition diagnosed at the time of admission. The diagnosis may not be made until 2-3 days after admission, after several visits, until the patient is discharged or not at all (if the person is an asymptomatic carrier). To protect yourself, you must consider all patients to have an infectious disease or, in other words, universally apply the same precautions to all body substances regardless of the source patient. ASEPSIS The first letter in our ABCs of infection control is "A", or asepsis. Practicing asepsis is a vital part of infection control practices. Handwashing, disinfection and sterilization are key parts of asepsis. Definition: Aseptic technique can be defined as all the measures we take to purposefully reduce the number of microorganisms (germs) to an irreducible number for the purpose of preventing transmission of infection. These include handwashing, disinfection and sterilization. There Are Many Levels of Asepsis The strictness (or level) of aseptic technique increases as you perform more invasive procedures. For example, taking a blood pressure requires only clean technique, while starting an IV requires sterile technique. The most invasive procedures (entering a sterile body cavity) require sterile technique. Disinfection: Removal of most pathogens (or disease-causing organisms) by the use of friction (cleaning) and a use of a disinfectant. -Clean high-touch items with a disinfectant frequently (bed rails, door knobs, over-the-bed tables, faucet handles, phones, etc.). -Use warm (not hot) water for mopping; hot water may burn someone if splashed and may strip the wax on floors when a "quat" is used. -Do not use a phenol in food preparation areas or on an infant crib/bassinet. Phenols are toxic if ingested and may harm an infant. Use a sanitizer in food preparation areas. -Check the label for "contact time," the amount of time the item must remain wet with the disinfectant to "kill" most of the pathogens, usually 10 to 20 minutes. -Dirt and soil inactivate disinfectants, so clean the area first. Then reapply a fresh layer of disinfectant and allow the area to remain wet for the contact time. Sterilization: The highest level of asepsis is defined by the removal of all microorganisms. It is achieved by autoclaving or by another sterilization process. Items must be thoroughly cleaned before sterilization can occur. -Reserved for instruments and other objects that enter sterile parts of the body. -When entering a sterile body cavity, skin antisepsis is needed with a skin antiseptic such as CHG or Betadine. -When opening sterile packets, make sure the sterilization indicators are changed. If not, report to Central Supply and do not use the item(s). All packages in that load need to be recalled. -Sterile items should remain sterile; protect the sterile field. Microorganisms Live in And on Our Bodies Transient: Transient microorganisms are easily picked up on hands, clothing, inanimate objects, etc., and are easily removed by handwashing and cleaning (physical removal of "germs"), antisepsis and disinfection. Antisepsis (or handwashing and pre-op skin preparation) is the removal of transient microorganisms from the skin with a reduction in the resident flora. Resident or Normal Flora: Those microorganisms that are constantly present on our bodies; no amount of scrubbing will totally remove them (the skin cannot be made sterile). These organisms cause "trouble" when introduced into normally sterile areas (like the bladder or bloodstream). Pathogens: Microorganisms that nearly always produce disease. For example: Salmonella and Shigella cause diarrheal illness upon ingestion of enough organisms. Normal flora can become pathogens when introduced into areas where they don't belong, for example, through insertion of a catheter or through surgery. Staph epidermis, normal flora of the skin, causes most central line infections and hip implants. The Seven Keys of Asepsis 1. Know what is clean 2. Know what is contaminated 3. Know what is sterile 4. Keep clean, contaminated and sterile items separated 5. Keep sterile sites sterile 6. Resolve contamination immediately 7. Train yourself to realize when you have broken technique Know what is clean: Clean techniques are any procedures that involve contact with intact skin or mucous membranes only. For example, when you are taking blood pressure or temperature, these articles need to be clean only. Know what is contaminated: Certain procedures like dressing changes produce contaminated materials. These contaminated materials must be disposed of properly by incineration or autoclave. Touching non-intact skin is a contaminated procedure; wear clean gloves unless a sterile procedure (like a dressing change) is being done. Know what is sterile: During certain procedures (for example, the insertion of an IV or urinary catheter), sterile technique should be used. The level of sterile procedures increases with the level of invasiveness. For example, surgical procedures require stricter aseptic technique than starting an IV. Sterile gloves are required for sterile procedures. Keep clean, contaminated and sterile items separated: Keep contaminated articles from touching clean or sterile items. Store clean and sterile items separately from contaminated areas or items. Keep sterile items from touching anything but a sterile field or another sterile item. Keep sterile sites sterile: Once a tube has been inserted into the body, care must be given to mitigate the travel of microorganisms up the catheter or tube. Give dressing changes or catheter care and replace catheters per your facility's policy and procedure. Resolve contamination immediately: If sterile technique cannot be used (during an emergency) or is broken, resolve contamination when it occurs. For example, if an IV is inserted during an emergency, replace the IV as soon as possible after the code is completed. Train yourself to realize when you have broken technique. If a technique is broken, remedy the problem if possible. For example, if during the insertion of an IV the catheter is contaminated (by dropping on floor, etc.), replace the catheter before insertion. If contamination cannot be resolved, report it to the proper person. For example, if the bowel is nicked during surgery, the case classification will change from clean contaminated to contaminated and extra care should be given to prevent infection. There Are Three Methods of Transmission of Infection Direct: Contact with a patient's blood and body fluid, secretions or excretions or by contact with items soiled with these substances (example: over-the-bed table, instruments, etc.). Indirect: Contact with food/drink or vermin. a. Vehicle: Contaminated food, water or article (VRE, Hepatitis A, Salmonella). b. Vector: Rats, roaches or insects (malaria, plague, hantavirus, West Nile virus). Vector is an uncommon means of transmission of nosocomial infections; in other words, "two-legged rats" (or humans) transmit more infections in the hospital than those with four legs! c. Airborne: Transmitted through bacteria contained in dust particles that remain airborne for long periods of time (chicken pox and tuberculosis). These diseases are highly infectious. A mask is needed for protection from these diseases. A special respirator is needed for tuberculosis. Handwashing Handwashing is the single most important means of preventing the spread of infection. Handwashing is a critical part of asepsis. Handwashing is stressed in the following areas: (This is not an all-inclusive list. Use your own conscience when washing hands.) 1) Before and after performing invasive procedures, whether or not sterile gloves are worn. 2) Before and after contact with wounds, whether surgical, accidental, or associated with an invasive device (e.g., an intravenous cannula entrance wound) whether or not sterile gloves are worn. 3) Before contact with particularly susceptible patients. 4) After contact with a source that is likely to be contaminated with virulent microorganisms or hospital pathogens, such as an infected patient or an object or device contaminated with secretions or excretions from patients (e.g., a urinary catheter system). 5) Between giving care to different sites of the body (e.g., measuring urine and giving IV site care). 6) Between direct contacts with different patients. 7) Before and after your shift. 8) Before and after eating, drinking or handling food. 9) After using the toilet, coughing or sneezing. 10) Whenever hands are visibly soiled. Antiseptics (such as CHG, PCMX, Triclosan, Betadine) should be used when performing invasive procedures, upon entering and leaving isolation rooms and in special care units (i.e., ICU, Nursery, Surgery). Antiseptic alcohol solutions may be used when handwashing facilities are not convenient, after casual contact with a patient (such as taking a pulse), but not when hands are visibly soiled. Rub hands together in the same manner as when washing hands. Allow to air dry. After approximately 10 applications, you may notice a buildup on hands. Simply remove by washing with soap and water. Friction is the most important part of handwashing. Rub for 10 to 15 seconds. Be sure to cleanse under and around nails and rings and backs of fingers. Rinse and dry hands adequately. Use a paper towel to turn off the faucet. Key Points: 1. Rinsing hands thoroughly and carefully drying hands will help to prevent chapping and cracking of hands. Pat hands dry. Roughly drying hands removes the top layer of your protective skin. 2. In patient care areas, use only hospital approved lotion in pump dispensers. Petroleum-based products (such as Vaseline Intensive Care) degrade latex. Most hand lotions inactivate the antimicrobial residue left on hands by agents such as chlorhexidine gluconate (CHG). A pump dispenser helps to protect the lotion from contamination. 3. In clinical areas, keep fingernails short and unpolished. Germs "hide" in the cracks in polish and under long or false nails and have been established as a link to transmission of infection. You can get naturally "polished" nails using a four-step buffing file. A good rule of thumb for nail length is to hold your hands with the palm side to you. If your nails are visible over your fingers, your nails are too long. BODY HYGIENE AND DRESS CODE The next letter of the ABCs of infection control is "B," or "Body Hygiene." Body hygiene is an extension of handwashing. Keeping clean and looking great help to form an atmosphere conducive to the practicing of asepsis and the ABCs of infection control. Scrub Attire Dress Code Wearing of scrub attire is usually designated as mandatory for the control of infection in the operating room. However, some operating rooms have recently allowed home laundering of scrub attire as a sterile gown is used to cover the uniform during the surgical procedure. Wearing of scrub attire (as uniforms) is usually permissible in other areas but not necessary for infection control purposes. Follow Good Habits of Personal Hygiene -Bathe or shower daily. -Keep your hair clean. -Cover, pull back or wear a hairnet for long hair at work. -Keep nails trimmed and clean. -Wear clean clothes every day. -Keep jewelry and cologne to a minimum. -Wash your uniform separately from household laundry. -in exposure prone areas: dietary, clinical personal Scrub Attire "Rules" Do not enter a restricted area without proper attire. Shoe covers, masks and head covers are not to be worn outside your work area (usually your department or the isolation room). Dispose of properly before leaving the area. Know and Follow Your Department Dress Code -Some departments have special dress codes. -Wear your identification badge. -Wear clean lab coats and shoes. Maintain Good Health If you maintain good health, you will be less likely to get and transmit infections. -Eat a balanced diet. -Get enough sleep. -Exercise regularly. -Practice healthy stress reduction measures. CARING ATTITUDE The last letter in our acronym for the ABCs of infection control is "C," or a Caring Attitude. A caring attitude will be reflected in work practices that support sound infection control principles. Work practices that support the maintenance of aseptic technique and embrace responsibility for each individual's role in Infection Control can only come from staff with caring attitudes. This can be accomplished by fostering a team approach through education and support of the clinician as they perform duties that are pivotal in the prevention and control of infection. Focus should be placed on the last of the ABCs of infection control (focusing on the right and wrong of infection control). Our attitudes should mirror the plan of asepsis -- common sense. By using common sense we can safely protect our patients and ourselves. Use common sense and a caring attitude to develop a good aseptic conscious (or a continuous awareness of asepsis). Your "aseptic consciousness" is your set of internal ideals. We have set ideals (in the form of policies and procedures) to protect our patients and ourselves. Set your ideals at the highest level to give care without doing harm. Conclusion The ABCs of infection control -- Asepsis, Body Hygiene and Caring Attitude -- comprise what we should do to help protect our patients and ourselves. Your diligence and common sense is key to protecting yourself, your co-workers and the patient. Handwashing and skin preparation, disinfectant and sterilization, vital parts of asepsis and a caring attitude, are essential to the ABCs of infection control. Infection control is a valuable asset to the facility and it is our responsibility to demonstrate this. OBJECTIVES: 1. Discuss the three major components of asepsis. 2. Discuss handwashing, disinfection and sterilization as they apply to asepsis. 3. Discuss body hygiene -- personal hygiene and dress code. 4. Explore developing a caring attitude -- a good sense of right and wrong essential to the practice of the ABCs of infection control. TEST QUESTIONS: TRUE OR FALSETF 1. Handwashing is a major part of asepsis. 2. The highest level of asepsis is sterilization. 3. Most infections transmitted in the hospital are vector-borne. 4. These comprise the ABCs of infection control: practicing aseptic technique, good body hygiene and developing a caring attitude. 5. Contact time is the time it takes for a disinfectant to kill what the label claims it will kill. 6. Asepsis is defined as the absence of bacteria. 7. Disinfection is defined as the total removal of all bacteria. 8. Airborne infections are transmitted by airborne dust particles. 9. Clean high-touch areas frequently. 10 If a sterile items indicator has not turned, report it to Central Supply. 11. Do not use a phenol in a food preparation area. 12. Dispose of protective attire when leaving your work area. 13. Infection control measures are not cost-effective. 14. A special respirator is required for tuberculosis. 15. Sterilization, a vital part of asepsis, means the absence of all bacteria. 16. Airborne infections are transmitted through bacteria contained in dust particles that remain airborne for long periods of time (such as chicken pox and tuberculosis). 17. Use warm (not hot) water to mop. 18. Dirt and soil inactivate disinfectants, so clean the area first. Then reapply a fresh layer of disinfectant and allow the area to remain wet for the contact time. 19. If laundering scrubs at home, it's okay to wash them with household laundry. 20. Getting enough sleep and eating healthy will help prevent infections. ANSWERS 1. T 2. T 3. F 4. T 5. T 6. F 7. F 8. T 9. T 10. T 11. T 12. T 13.F 14. T 15. T 16. T 17. T 18. T 19. F 20. T

Here is an article I wrote on TB screening. Hope it may be of some use to someone. It didn't cut and paste to well (the charts), but if anyone wants it, PM me and I'll send it to you. TB Skin Testing Melba Rhodes, RN, BSN, CIC Objectives: Discuss the administration, reading and interpretation of the TB skin test. Discuss reasons for false positives and false negatives. The TB Skin TestThe tuberculin skin test is used to determine whether a person has TB infection or latent TB (non-infectious). A substance called tuberculin is injected in between the layer of the skin (intradermally). Tuberculin is protein derived from tubercle bacilli that have been killed by heating. In most people who have TB infection, the immune system will recognize the tuberculin because it is similar to the tubercle bacilli that caused the infection. This will cause a reaction to the tuberculin. Tuberculin is used for diagnosing TB infection; it is not a vaccine.A health care worker (usually a nurse) will inject a small amount of testing fluid (called tuberculin) just under the skin on the lower part of your arm. Do not scratch or rub the site. After 2 or 3 days, the health care worker will measure your reaction to the test. You may have a small bump where the tuberculin was injected. The health care worker will measure this bump and tell you if your reaction to the test is positive or negative. A positive reaction usually means that you have latent (inactive) TB infection. A TB skin test is the only way to find out if you have latent (inactive) TB infection. You should get tested for TB if you: þ Have spent time with a person with known or suspected to have TB disease þ Have HIV infection or another condition that puts you at high risk for TB disease þ Think you might have TB disease þ Are from a country where TB disease is very common (most countries in Latin America and the Caribbean, Africa, Asia, Eastern Europe, and Russia) þ Inject drugs þ Live or work somewhere in the U.S. where TB disease is more common (homeless shelters, migrant farm camps, prisons and jails, hospitals, and some nursing homes) þ Are a Healthcare Worker If you have a positive reaction to the skin test, you will need other tests to see if you have TB disease. These tests usually include a chest x-ray and a test of the material you cough up. A positive skin test does not mean that you cannot continue to work. As long as you have no symptoms of TB (cough, night sweats, fever, weight loss, etc.), you can continue to work. If you have TB disease, you will need to take medicine to cure the disease. This medication is the same medication used to treat active TB. You will generally take the medication for 6 to 9 months. If you have recently spent time with someone with infectious TB, your skin test reaction may not be positive yet. It takes about 8 weeks for the skin test to become positive after infection. You may need a second skin test 10 to 12 weeks after the last time you spent time with the infectious person. If your reaction to the second test is negative, you probably do not have latent (inactive) TB infection. You should report any symptoms of TB (i.e.; cough lasting longer than two weeks, fatigue, coughing up blood) to the Employee Health Office immediately. How can you prevent exposure to tuberculosis? 1. Screen each patient upon admit for signs and symptoms of TB. Your policy may call for administering a TB skin test upon admit and annually. 2. Wear an N95 Respiration when treating a patient with suspected or known TB. The patient should be isolated in a negative pressure room. If your facility does not have a negative pressure isolation room, have the patient wear a surgical mask (if coughing) while TB is being ruled out or the patient is being transferred. Post test instructionsAs the tuberculin solution is injected, a 6 to 10 mm wheal will raise up at the site. This is quickly absorbed and no dressing is required.Do not massage the site. Doing so may cause the medication to disperse into the tissue or leak out of the site.Apply slight direct pressure if the site bleeds.Do not rub area when bathing or use perfume or lotion on the site.Do not put an adhesive bandage over the site.Return to have test read when instructed, no longer than 72 hours. If test is not read then, it will need to be repeated.Notify the employee Health Nurse of any itching or redness at the site within the first 15 minutes of application.Reports of delayed reaction have occurred. Report any hardened area that occurs for up to 14 days after application. This may indicate early TB infection and the test should be repeated in a month. TB Skin TestingTB skin testing is a test of the body’s reaction to purified protein derivative (PPD) of tuberculin via delayed type hypersensitivity (similar to the body’s reaction to poison ivy). This delayed reaction typically appears 48 to 72 hours after placement of the TB skin test. False Positive False Negative Atypical mycobacterium infection (MAC, m. bovine, etc.) Recent vaccination (Rubella, measles, influenza) Infant under 6 months (due to immature immune system) Early in TB infection or disease (it takes about 2 months for hypersensitivity reaction to the TB skin test to develop) Immunosupression (Hodgkin’s, AIDS, Large dose corticosteroids) Pen Method of Measuring TB Skin Tests The reaction is an area of induration (swelling that can be felt) around the site of the injection. The diameter of the indurated area is measured across the forearm. 1. Place a pen about 2 inches away from the suspected induration (ignore the redness). 2. Glide the pen until you meet resistance. 3. Do the same from the other direction. 4. Measure the distance between the 2 lines. Classifying the ReactionWhether a reaction to the Mantoux tuberculin skin test is classified as reactive depends on the size of the induration and the person's risk factors for TB. 5 or more millimeters is considered a positive reaction for the following people: - People with HIV infection - Close contacts of people with infectious TB - People with chest x-ray findings suggestive of previous TB disease - People who inject illicit drugs and whose HIV status is unknown 10 or more millimeters is considered a positive reaction for the following people: - People born in areas of the world where TB is common (foreign-born persons) - People who inject illicit drugs but who are known to be HIV negative - Low-income groups with poor access to health care - People who live in residential facilities (for example, nursing homes or correctional facilities) - People with medical conditions that appear to increase the risk for TB (not including HIV infection), such as diabetes - Children younger than 4 years old - People in other groups likely to be exposed to TB, as identified by local public health officials 15 or more millimeters is considered a positive reaction for people with no risk factors for TB. In most cases, people who have a very small reaction or no reaction probably do not have TB infection. What about BCG Vaccination? There is NO RELIABLE WAY to distinguish a positive tuberculin reaction caused by vaccination with BCG from a reaction caused by true TB infection. However, the reaction is more likely to be due to TB infection if any of the following are true: - The reaction is large - The person was vaccinated a long time ago - The person comes from an area of the world where TB is common - The person has been exposed to someone with infectious TB disease - The person's family has a history of TB disease TRUE or FALSE 1. It takes about 25 weeks for the skin test to become positive after infection. 2. Symptoms of TB include cough and night sweats. 3. A positive TB skin test means you cannot work in a healthcare facility. 4. If you have TB disease, you will need to take medicine to cure the disease. 5. Reports of delayed reaction, up to 14 days after application, have occurred. 6. A TB skin test is the only way to find out if you have latent TB infection. 7. If you have a positive reaction to the skin test, you will need other tests to see if you have TB disease. 8. A false positive may be caused by recent vaccination. 9. Wear an N95 Respiration when treating a patient with suspected or known TB. 10. If test is not read within 72 hours it will need to be repeated. Answers 1. False 2. True 3. True 4. True 5. True 6. True 7. True 8. False 9. True 10. True

I have another comment about VRE. just keep in mind VRE can survive up to two weeks on enviromental surfaces for 2 weeks or longer, so good terminal cleaning is esential after these cases. Please contact me if further info is needed. An IC Nurse [email protected]