15 Miss. Code. R. 16-1-49.16.6 - Employee Testing for Tuberculosis
1. Each employee,
upon employment of a licensed entity and prior to contact with any
patient/client, shall be evaluated for tuberculosis by one of the following
methods:
a. IGRA (blood test) and an
evaluation of the individual for signs and symptoms of tuberculosis by medical
personnel; or
b. A two-step
Mantoux tuberculin skin test administered and read by a licensed
medical/nursing person certified in the techniques of tuberculin testing
and an evaluation of the individual for signs and symptoms of
tuberculosis by a licensed Physician, Physician's Assistant, Nurse Practitioner
or a Registered Nurse.
2. The IGRA/Mantoux testing and the
evaluation of signs/symptoms may be administered/conducted on the date of hire
or administered/read no more than 30 days prior to the individual's date of
hire; however, the individual must not be allowed contact with a patient or
work in areas of the RBIR where patients have access until receipt of the
results of the IGRA/assessment or at least the first of the two-step Mantoux
test has been administered/read and assessment for the signs and symptoms
completed.
3. If the Mantoux test
is administered, results must be documented in millimeters. Documentation of
the IGRA/TB skin test results and assessment must be documented in accordance
with accepted standards of medical/nursing practice and must be placed in the
individual's personnel file no later than 7 days of the individual's date of
employment. If an IGRA is performed, results and quantitative values must be
documented.
4. Any employee noted
to have a newly positive IGRA, a newly positive Mantoux skin test or
signs/symptoms indicative of tuberculin disease (TB) that last longer than
three weeks (regardless of the size of the skin test or results of the IGRA),
shall have a chest x-ray interpreted by a board certified Radiologist and be
evaluated for active tuberculosis by a licensed physician within 72 hours. The
employee shall not be allowed to work in any area where clients have routine
access until evaluated by a physician/nurse practitioner/physician assistant
and approved to return. Exceptions to this requirement may be made if the
employee is asymptomatic and:
a. The
individual is currently receiving or can provide documentation of having
received a course of tuberculosis prophylactic therapy approved by the
Mississippi State Department of Health (MSDH) Tuberculosis Program for
tuberculosis infection, or
b. The
individual is currently receiving or can provide documentation of having
received a course of multi-drug chemotherapy approved by the MSDH Tuberculosis
Program; or
c. The individual has
a documented previous significant tuberculin skin reaction or IGRA reaction.
5. For individuals
noted to have a previous positive to either Mantoux testing or the IGRA, annual
re-evaluation for the signs and symptoms must be conducted and must be
maintained as part of the employee's annual health screening. A follow-up
annual chest x-ray is NOT required unless symptoms of active tuberculosis
develop.
6. If using the Mantoux
method, employees with a negative tuberculin skin test and a negative symptom
assessment shall have the second step of the two- step Mantoux tuberculin skin
test performed and documented in the employees' personal record within fourteen
(14) days of employment.
7. The
IGRA or the two-step protocol is to be used for each employee who has not been
previously skin tested and/or for whom a negative test cannot be documented
within the past 12 months. If the employer has documentation that the employee
has had a negative TB skin test within the past 12 months, a single test
performed thirty (30) days prior to employment or immediately upon hire will
fulfill the two-step requirements. As above, the employee shall not have
contact with clients or be allowed to work in areas of the RBIR to which
clients have routine access prior to reading the skin test, completing a signs
and symptoms assessment and documenting the results and findings.
8. Facilities shall comply with
recommendations from the Centers for Disease Control and/or the Mississippi
State Department of Health regarding baseline employee TB testing and routine
serial employee TB testing and education. Staff exposed to an active infectious
case of tuberculosis shall be treated as contacts and be managed appropriately.
Individuals found to have a significant Mantoux tuberculin skin test reaction
and a chest x-ray not suggestive of active tuberculosis, shall be evaluated by
a physician or nurse practitioner/physician assistant for treatment of latent
tuberculin infection.
9. Each
employee, upon employment of a licensed entity and prior to contact with any
patient/client, shall be evaluated for tuberculosis by one of the following
methods:
a. IGRA (blood test) and an
evaluation of the individual for signs and symptoms of tuberculosis by medical
personnel; or
b. A two-step
Mantoux tuberculin skin test administered and read by a licensed
medical/nursing person certified in the techniques of tuberculin testing and an
evaluation of the individual for signs and symptoms of tuberculosis by a
licensed Physician, Physician's Assistant, Nurse Practitioner or a Registered
Nurse.
10. The
IGRA/Mantoux testing and the evaluation of signs/symptoms may be
administered/conducted on the date of hire or administered/read no more than 30
days prior to the individual's date of hire; however, the individual must not
be allowed contact with a patient or work in areas of the RBIR where patients
have access until receipt of the results of the IGRA/assessment or at least the
first of the two-step Mantoux test has been administered/read and assessment
for the signs and symptoms completed.
11. If the Mantoux test is administered, results must be
documented in millimeters. Documentation of the IGRA/TB skin test results and
assessment must be documented in accordance with accepted standards of
medical/nursing practice and must be placed in the individual's personnel file
no later than 7 days of the individual's date of employment. If an IGRA is
performed, results and quantitative values must be documented.
12. Any employee noted to have a newly
positive IGRA, a newly positive Mantoux skin test or signs/symptoms indicative
of tuberculin disease (TB) that last longer than three weeks (regardless of the
size of the skin test or results of the IGRA), shall have a chest x-ray
interpreted by a board certified Radiologist and be evaluated for active
tuberculosis by a licensed physician within 72 hours. The employee shall not be
allowed to work in any area where clients have routine access until evaluated
by a physician/nurse practitioner/physician assistant and approved to return.
Exceptions to this requirement may be made if the employee is asymptomatic and:
a. The individual is currently receiving or
can provide documentation of having received a course of tuberculosis
prophylactic therapy approved by the Mississippi State Department of Health
(MSDH) Tuberculosis Program for tuberculosis infection, or
b. The individual is currently receiving or
can provide documentation of having received a course of multi-drug
chemotherapy approved by the MSDH Tuberculosis Program; or
c. The individual has a documented previous
significant tuberculin skin reaction or IGRA reaction.
13. For individuals noted to have a previous
positive to either Mantoux testing or the IGRA, annual re-evaluation for the
signs and symptoms must be conducted and must be maintained as part of the
employee's annual health screening. A follow-up annual chest x-ray is NOT
required unless symptoms of active tuberculosis develop.
14. If using the Mantoux method, employees
with a negative tuberculin skin test and a negative symptom assessment shall
have the second step of the two- step Mantoux tuberculin skin test performed
and documented in the employees' personal record within fourteen (14) days of
employment.
15. The IGRA or the
two-step protocol is to be used for each employee who has not been previously
skin tested and/or for whom a negative test cannot be documented within the
past 12 months. If the employer has documentation that the employee has had a
negative TB skin test within the past 12 months, a single test performed thirty
(30) days prior to employment or immediately upon hire will fulfill the
two-step requirements. As above, the employee shall not have contact with
clients or be allowed to work in areas of the RBIR to which clients have
routine access prior to reading the skin test, completing a signs and symptoms
assessment and documenting the results and findings.
16. Facilities shall comply with
recommendations from the Centers for Disease Control and/or the Mississippi
State Department of Health regarding baseline employee TB testing and routine
serial employee TB testing and education. Staff exposed to an active infectious
case of tuberculosis shall be treated as contacts and be managed appropriately.
Individuals found to have a significant Mantoux tuberculin skin test reaction
and a chest x-ray not suggestive of active tuberculosis, shall be evaluated by
a physician or nurse practitioner/physician assistant for treatment of latent
tuberculin infection.
Notes
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