question for correctional nurses about TB

I work acute care for inmates. I know that in my state, inmates get a PPD when they arrive to prison and every 6 months.

At our acute care facility, doc's go waaay overboard on ruling out TB. If the I/M has even a slight possibility of TB they are placed in isolation, AFB is ordered and they are in isolation until all 3 AFB's are cultured with negative results. They say that just getting a PPD is not enough. Did I mention overboard?? No one has tested positive ever and I have worked there for years.

It seems that the prisons are doing a good job of containing it from what I have seen. I would think if an inmate tests positive, they get a CXR and if that confirms it, they are then quarantined until they have treatment and are no longer contagious.

We test on intake and then annually. One active case in an HIV co-infected inmate got into population for a couple months, it was a bit of a nightmare contacting every inmate or employee that had contact with him to test, no one else was positive. Active cases go to a negitive pressure room upstate. Positive reactors get a review of symptoms and chest xray.

I don't think my state does enough, especially in light of the fore mentioned case. I think we should be doing 2 step ppd's on all imuno-compromised clients and clients over 65. We have been lucky so far to only have the one active case slip by.

How is TB contained in a correctioinal facility? We have 26 negative pressure rooms.

how is it kept in check amoung the inmate Population? They get PPD's at intake and every 6 months after that.

do these inmates get transferred out some where? No. They are placed in the negative pressure rooms in our institution.

has it been a problem? I havent been there long but I do know that they had an inmate test positive for TB and everyone that was around him had to be tested and treated with prophylactics.

Has any Correctional Nurse tested positive (+) since being employed @ a facility? This I don't know. I dont think so but I will ask. :)

I don't think my state does enough, especially in light of the fore mentioned case. I think we should be doing 2 step ppd's on all imuno-compromised clients and clients over 65. We have been lucky so far to only have the one active case slip by.

You are absolutely right about the 2 steps on all immuno-compromised clients and clients over 65. They need to take it more seriously than what they do! I think it should be the same across the board since they live in such crowded and confined conditions where TB can spread quickly.

You are absolutely right about the 2 steps on all immuno-compromised clients and clients over 65. They need to take it more seriously than what they do! I think it should be the same across the board since they live in such crowded and confined conditions where TB can spread quickly.

~first off~

Thank you guys/gals so much for all the responses about TB and how it affects you and your facility, etc.,

Id like to think that all facilitys take TB seriously. why wouldnt they?

I do however know that having had friends that work in corrections, etc., that it is not always taken seriously. IT IS SCARY TO THINK OF A HUGE facility with over 700 inmates and over 300 full time staff, employee's, etc., not taking it seriously!

Is there one or two designated individuals assigned to monitor the inmates and incoming for TB? FOR example, like an infectious disease nurse?

thanks to all,

romiia

~MIA~