Guidelines on the Prevention and Control of Tuberculosis in Ireland

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<strong>Guidelines</strong> on the Prevention and Control of Tuberculosis in Ireland 2010HSE/HPSCClinicalWorkPracticeSafeInjectionPracticesPracticesfor lumbarpunctureproceduresSTANDARD PRECAUTIONS AIRBORNE PRECAUTIONSAdministrationEducate all HCWs who administer injections on the importance of safe injection practicesAll facilities should have a guideline on the use of multi-dose vials.No additional precautions necessaryPreparation of InjectionsAll injections should be prepared in a clean area. This area must not be used for disposing of used needlesand syringes, handling blood samples or any material contaminated with blood or body fluidsAn aseptic technique must be used when drawing up injectionsNeedles, syringes and cannulae are sterile, single use items; they must not be reused for another patient norto access a medication or solution that might be used for a subsequent patientUse single dose vials wherever possibleDo not use single dose vials for multiple patientsDo not combine leftovers for later useMulti-dose vialsMulti-dose vials should only be used when absolutely necessaryRestrict wherever possible the use of multi-dose vials to a single patientLabel vial with patient’s name and date openedDiscard if sterility is compromised or questionableDo not leave multi-dose vials at a patient’s bedsideUse a sterile syringe and needle every time a medication vial is accessed even if it is a 2 nd dose of the samedrug for the same patient.Infusions and intravenous setsDo not use bags or bottles of intravenous fluids as a common source of supply for multiple patientsIntravenous fluids and intravenous sets are single use sterile items for use by a single patientConsider a syringe or needle/cannula contaminated once it has been used to enter or connect to a patient’sintravenous infusion bag or administration set.When inserting a catheter, injecting material/chemotherapy into the spinal canal or subdural space,healthcare workers should wear a surgical mask and adhere to aseptic technique.No additional precautions necessary-183-
<strong>Guidelines</strong> on the Prevention and Control of Tuberculosis in Ireland 2010HSE/HPSCAppendix 11: Discharge instructions for patients with potentiallyinfectious TBYou have been placed on medication to treat TB. You are now being discharged home from hospital.However, your TB may remain infectious (contagious) for some time longer. A number of generalinstructions and temporary restrictions are therefore being advised until it is certain that you are no longerinfectious to others. These restrictions will help reduce any possibility of spread of TB germs to otherpeople. You should follow them carefully until you are advised otherwise by the doctor who is treatingyour TB.General instructions:• Take your TB medications as instructed by your doctor• You should always cover your nose and mouth with a tissue when coughing or sneezing• Dispose of used tissues in a bin immediately after use and wash your hands• It is ok to share eating utensils (spoons, forks, cups or glasses) and other household items• Keep your doctor’s or clinic appointment so that you complete your treatment.Temporary restrictions after hospital discharge• Do not go to work or school and you should avoid going to any public areas (e.g. cinema, pubs orclubs, using public transport) until the doctor who is treating your TB says it is ok for you to do so.• If there are others living at home you should- limit the time you spend in common household areas (e.g. kitchen or living room) and keepyour bedroom door closed- If advised by your doctor to wear a surgical mask (as a temporary measure) that covers yournose and mouth (as explained to you in hospital) when you are around other people, follow theinstructions given. This will reduce the number of TB germs that you put into the air when youcough or talk.• You should not be around babies, young children or, to the best of your knowledge, people whohave weakened immune systems such as people with HIV/AIDS. (If there are young children athome, you may still be discharged home if the children have been tested for TB infection and arebeing followed up by the local public health department).These temporary restrictions will be removed once your doctor decides that you are no longer infectious.However, your TB treatment will continue until the course is completed.If you have any questions about your treatment, please call ……………………………….……Adapted with kind permission from Tuberculosis, Clinical Policies and Protocols. New York City Departmentof Health and Mental Hygiene (2008). Available from www.nyc.gov/html/doh/downloads/pdf/tb/tbprotocol.pdf.-184-
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Guidelines on the Prevention and Control of Tuberculosis in Ireland

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