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Infection Control Overview: TB
Session 1: Infection Control Basics
Learning Objectives

This session deals with the control of TB

By the end of the session, participants will be able
to protect themselves and others from TB
1: Infection Control Overview - TB
Slide 2
Steps to Prevent the Spread of TB to
Staff and Patients

Detect infectious patients early

Ensure cross ventilation and wear masks during coughinducing procedures

Leave windows open and direct air flow from staff to
patients

Separate AFB smear positive patients from others

Instruct patients to turn their head and cover their mouth
when coughing
1: Infection Control Overview - TB
Slide 3
Early Detection and Treatment of TB
Protects You!

TB is the greatest hazard nurses face

Most infections are passed from patients, visitors
and staff whom no one suspects of having TB
1: Infection Control Overview - TB
Slide 4
Our visitor has been coughing
for three weeks and is losing weight!
1: Infection Control Overview - TB
Slide 5
Doctor, we are sending you a
person to be evaluated for TB. Please let us know
when she can come back to the ward
1: Infection Control Overview - TB
Slide 6
Have Chronic Coughs Evaluated

A cough greater than 3
weeks should be
evaluated whether in you,
another staff member, a
visitor, a volunteer, family
member or patient

Act early!
1: Infection Control Overview - TB
Slide 7
Discussion: Tuberculosis and Nurses
 What
are the tasks that puts you at
most risk for contracting TB?
1: Infection Control Overview - TB
Slide 8
Cough Producing Procedures that put HealthCare Personnel at Risk
Bronchoscopy
1: Infection Control Overview - TB
Slide 9
Cough Producing Procedures that put HealthCare Personnel at Risk (cont’d)
Getting a sputum specimen
1: Infection Control Overview - TB
Slide 10
Cough Producing Procedures that put HealthCare Personnel at Risk (cont’d)
Suctioning
1: Infection Control Overview - TB
Slide 11
Cough Producing Procedures that put HealthCare Personnel at Risk (cont’d)
Nebuliser treatments
1: Infection Control Overview - TB
Slide 12
What are the Risks Involved in these
Procedures?

Surgery

Placing intercostal drains

Handling mycobacterium cultures

Cleaning suction cups

Post-mortem
1: Infection Control Overview - TB
Slide 13
Discussion: High Risk Procedures

Before proceeding for bronchoscopy, what
precautions should you follow?

In what way may you be putting yourself or your
patients at risk?

How could this be improved?

How is this similar or different from other high-risk
procedures?
1: Infection Control Overview - TB
Slide 14
TB (N95) Masks
TB masks should be used
during high risk
procedures:
1: Infection Control Overview - TB

N95 mask has a filter
efficiency of 95%

Can be reused until
contaminated or clogged

Must be discarded when
breathing becomes difficult
Slide 15
Do other Masks Help?

A paper or cloth mask can get
wet in as little as 10 minutes,
allowing bacteria to pass

If mask is not tight over the
nose and mouth, unfiltered air
will be sucked in around the
nose and cheeks

What is more important than
masks?

Early detection and treatment

Good ventilation

Isolation of pulmonary TB
cases
1: Infection Control Overview - TB
Slide 16
Other Factors that put Staff at Risk:
No cross breeze

Patients care areas
without 2 open facing
windows
DANGER:

Bronchoscopy suite
without windows or
outside airflow
1: Infection Control Overview - TB
Slide 17
Protect Yourself with Good Ventilation

Open windows

See patients in rooms
with a window on each
side of the room
1: Infection Control Overview - TB
Slide 18
Protect Yourself with Good Ventilation (cont’d)
Health worker
Patient
Proper Airflow Direction
1: Infection Control Overview - TB
Slide 19
Open window
How can you Reduce the Risk of TB for
these Staff?

Nurse placing PPD’s
in center of the office

Clerical staff entering
records behind in
office near window
1: Infection Control Overview - TB
Slide 20
Instruct Coughing Patients to Turn
their Heads, and Cover their Mouths

Cover the mouth with
a cloth, a sleeve or a
sari to stop germs
going into the air
1: Infection Control Overview - TB
Slide 21
Protecting Yourself and Others from TB

Separate infectious TB (smear + or smears
pending) patients from other patients

Staff who do not work directly with patients should
not enter areas with infectious TB patients
1: Infection Control Overview - TB
Slide 22
Which is the Most Dangerous Mix of Patients
and Why?

HIV - and HIV +

Smear + TB and HIV +

MDRTB smear + and HIV+

MDRTB smear + and HIV -
1: Infection Control Overview - TB
Low risk
Slide 23
High risk
Greatest Risk!
High risk
Don’t Mix Non-Infectious TB and Infectious
TB Patients
Questions for discussion:

When do we consider people non-infectious?

What precautions should we take with patients
who are on ARVs?
1: Infection Control Overview - TB
Slide 24
MDRTB Patients Should not Mix
with other Patients

Multiple drug resistant TB (MDRTB) is not
treatable by first line treatment

50% or more who develop MDRTB disease
will die

These patients must not be in the same building
as uninfected persons

Patients in a hospital can infect more people than
at home
1: Infection Control Overview - TB
Slide 25
Summary: Steps to Protect Yourself and
Others from TB

Ensure a cross breeze, open windows and the
direction of air flow from the health care worker to
the patient to outside

Separate non-infected patients from patient who
are, or might be infectious

Have patients turn their head and cover their
mouth when they cough

Keep non-essential staff out of areas with
infectious patients or cough-inducing procedures
1: Infection Control Overview - TB
Slide 26
Key Points

Preventing the spread of TB includes:

Early detection and treatment

Strict isolation of smear positive patients

Good ventilation

Extra precautions during cough inducing procedures

Attention to patient placement

Teaching cough hygiene
1: Infection Control Overview - TB
Slide 27
BREAK