Program Manual - Saint Louis University

5. HCWs who are PPD status positive will have medical history performed including questions for Tuberculosis
symptomatology. The HCW must provide documentation of the positive PPD including the result (in
millimeters of induration), documentation of evaluation for preventative therapy, any preventative treatment
documents, and a negative chest x-ray report from within one year
a. If the HCW is asymptomatic, HCW is cleared for patient care/work.
b. If the HCW is symptomatic or does not have a negative chest x-ray report from within one year, a chest xray
is provided by Employee Health.
1) If the chest x-ray and medical screening are negative, the HCW is cleared for patient care/work.
2) If the chest x-ray and/or medical screening are positive, the HCW is referred to the appropriate public
health department for treatment. Alternatively, the HCW may consult their private medical
physician. Documents must be provided for review. The HCW is cleared for patient care/work when
the infectious status is known to be non-communicable.
B. Annual Tuberculosis Screening
Each individual HCW (as defined under POLICY section p.1) will be screened annually. Screenings will occur
every six months. In February of each year, HCWs with last names starting M-Z will be screened. In August of
each year, HCWs with last names starting A-L will be screened.
1. PPD status negative: PPD (Mantoux) test is administered and read 48 to 72 hours after administration.
a. If the PPD result is negative, HCW is cleared to continue patient care/work.
b. If the PPD result is positive, a chest x-ray is provided by Employee Health. HCW is evaluated at
Employee Health.
1) If the chest x-ray and medical screening are negative, the HCW is cleared to continue patient
care/work. Evaluation for preventative therapy is provided at Employee Health.
2) If the chest x-ray and/or medical screening are positive, the HCW is evaluated and treated through
Employee Health. The HCW is cleared to continue patient care/work when the infectious status is
known to be non-communicable.
2. PPD status positive: Medical health screening including Tuberculosis screening questionnaire is
administered.
a. If the HCW is asymptomatic, the HCW is cleared to continue patient care/work.
b. If the HCW is symptomatic, evaluation and chest x-ray are provided by Employee Health.
1) If the chest x-ray and medical screening are negative, the HCW is cleared to continue patient
care/work when the infectious status is known to be non-communicable.
2) If the chest x-ray and/or medical screening are positive, the HCW is evaluated and treated through
Employee Health. The HCW is cleared to continue patient care/work when the infectious status is
known to be non-communicable.
C. HCW groups at increased risk HCWs in selected departments at increased risk for TB exposure are tested and
assessed every six months. The departments included are: Anatomic Pathology, Clinical Microbiology,
Emergency Department, Pulmonary Medicine, Diagnostic Radiology, Respiratory Care.
D. Contracted Services HCW Tuberculosis Screening Annual Tb screening will include all contracted service
HCWs: Environmental Services, Dietary, Building Services. In the event that a positive PPD result is obtained, a
chest x-ray will be provided by Employee Health. Otherwise, the contracted service HCW will be followed up in
accordance with the procedures of the specific contracted service company. Documentation of follow up for
contracted service HCWs with a positive PPD must be submitted to Employee Health.
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