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Discussion

TB Assessment Form

I'm new to school nursing and I've been asked to do the TB assessment forms for staff members. I know what to look for and am quite familiar with the disease, but I was curious if I shouldn't sign off if a staff member hasn't had a PPD test done in the last 2 years? One of the staff members said another nurse wouldn't sign off because they haven't had the test in several years, but they are not a risk otherwise. Was just curious on that.

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    This is something the district (or above) should have a policy on. We had a number of TB cases in various districts in our state over the past years, so everybody gets tested periodically. Employees used to only be tested on hire. Now it gets repeated every few years.

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    Thank you! That is very helpful and makes perfect sense. I can see how it would depend on the number of outbreaks in each area.

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    Former TB nurse here. The screening forms may or may not be useful. And...what are you going to do with a staff person who spent the summer in a high-risk area? Has a cough of nine months' duration (don't laugh - that happened and three docs missed it).

    My favorite nurse manager used to say "a decision to test is a decision to treat." If you're screening them, are you legally responsible for testing? The PPD is very tetchy, especially if you've had a BCG or grown up in a high risk area, or, say, been treated before...

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    That is very helpful and really good points ruby_jane! My understanding is to refer them to a clinic or to be tested if they are showing symptoms or were in a high-risk area. That's crazy to miss a cough for 9 months!

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    I think your HR people need to engage a local Occupational Health program.

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