Shelters and TB

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Shelters and TB,What Staff Need to Know,VIEWER S GUIDE. SECOND EDITION 2013, The Curry International Tuberculosis Center is a project of the University of California San Francisco. and funded by the Centers for Disease Control and Prevention under Cooperative Agreement. 1U52 PS004088 1, Permission is granted for non profit educational uses and library duplication and distribution. Suggested citation, Curry International Tuberculosis Center Shelters and TB What Staff Need to Know Second. Edition January 2013 inclusive page numbers, Shelters and TB What Staff Need to Know was filmed on location at the St Boniface Neighborhood.
Center in San Francisco CA U S A in October 2004,Date of original release December 2004. Date of second edition CD release January 2008 December 2013. Total video running time 18 minutes, This guide and video is available on the Curry International Tuberculosis Center website. http www currytbcenter ucsf edu, Feedback and comments related to this product are welcome please email CurryTBcenter ucsf edu. Acknowledgements, The following individuals are gratefully acknowledged for this invaluable participation and guidance. in this project, Janet Abernathy R N B S N C O H N S San Ramon Regional Medical Center San Ramon California.
Annette Nitta M D Los Angeles County Department of Health Services Los Angeles California. Eve Rubel M P H Homeless Health Care Los Angeles Los Angeles California. Robert Smith M P H Homeless Health Care Los Angeles Los Angeles California. The following organizations were instrumental in creating the original product. Centers for Disease Control and Prevention Atlanta Georgia. Dutch Shisler Sobering Center Seattle Washington, Homeless Health Care Los Angeles Los Angeles California. Multi Services Center South San Francisco California. National Health Care for the Homeless Council Albuquerque New Mexico. National Health Care for the Homeless Council HCH Clinicians Network Seattle Washington. Oregon State Health Department Portland Oregon, San Francisco Department of Public Health San Francisco California. St Boniface Neighborhood Center San Francisco California. Union Gospel Mission Mission s Men s Shelter Seattle Washington. Wasatch Homeless Health Care Inc and University of Utah School of Medicine Salt Lake City Utah. Washington State Department of Health Olympia Washington. Zamacona Productions San Francisco California,Document prepared by. Jeannie Fong James Sederberg Lily Lam Curry International Tuberculosis Center. Graphic design,Edi Berton Design,Cover photo provided by. Casa Esperanza Homeless Shelter Santa Barbara California. Helen Wong R N P H N, Shel t ers a n d T B W h a t S t a f f Ne e d t o Kn o w 2 n d Ed itio n I.
Table of Contents,ABOUT THIS VIDEO AND VIEWER S GUIDE iii. LEARNING OBJECTIVES iv,INTRODUCTION 1,WHAT IS TUBERCULOSIS TB 2. FREQUENTLY ASKED QUESTIONS FAQS 7, WHAT SHELTER STAFF CAN DO TO PREVENT THE SPREAD OF TB 8. Frontline Staff 8,Managers and Administrators 11,SUMMARY 17. GLOSSARY 18,RESOURCES 19,Reading Materials 19,Organizations 20.
APPENDIX 21,TB Control Plan Annual Shelter Risk Assessment 22. Tuberculosis TB Curriculum 23,Tuberculosis TB Curriculum Sign In Sheet 24. TB Assessment for Clients Questions and Procedures 25. Employee s Annual Tuberculosis Screening Questionnaire 26. Tuberculin Skin Test Log 27,Cough Alert Policy and Procedures 28. Cough Log 29,Poster Ideas 30,Sample Posters 31 32,Important TB Contacts 33. About This Video and Viewer s Guide, he Curry International Tuberculosis Center is pleased to develop this video and viewer s guide.
to help your shelter create a healthy and safe environment Our goal is to help address. concerns and reduce fears that you may have about working with clients or staff who may. have tuberculosis TB This fundamental TB infection control information can help you and your staff. prevent the spread of TB,Target Audience, Homeless shelter staff frontline staff managers volunteers and others. Staff of congregate group home settings,How to Use These Materials. The video and viewer s guide can be used either as an independent self study or in a group setting. This video has two parts which allows for flexibility so staff can view the entire video at one time or. depending on specific needs a part at a time Although the first part is geared towards frontline. shelter staff and the second part is geared towards shelter administrators both groups can benefit. from watching the entire video A sample TB curriculum can be found in the Appendix section to help. a trainer or facilitator plan a TB training, Video The first part of this video is for frontline shelter staff who work directly. with clients You will learn about TB how it is spread and what to do when. you suspect someone has TB, The second part of this video is for shelter managers You will learn about. TB infection control policies and procedures and how these policies help. create a healthy and safe shelter environment for staff and clients This. section also shows how you and your local health department can work. together to prevent the spread of TB, Viewer s Guide The accompanying viewer s guide expands on the content covered in.
the18 minute video and serves as a reference guide containing additional. information resources templates and checklists to help establish your. shelter s TB infection control policy To maximize your learning experience. we recommend that you read the viewer s guide after watching the video. A Word About Recommendations, Efforts have been made to ensure that this video and viewer s guide includes applicable. recommendations from the Centers for Disease Control and Prevention However it may not address. every issue of interest to all regulatory agencies Since regulations and guidelines may vary by county. and state facilities should review local state and federal guidelines when applying this information to. their programs, Shelters and TB What Staff Need to Know 2nd Edition III. Learning Objectives, After viewing the video and viewer s guide you will be able to. 1 Identify 3 steps to take if you suspect someone has Tuberculosis TB. 2 Explain how TB is spread, 3 Explain 2 differences between TB disease and TB infection. 4 List 3 risk factors for developing TB disease,5 Describe 3 ways to prevent the spread of TB.
6 List 2 reasons why patients need to complete treatment for active TB disease. Introduction, y using this video and viewer s guide to learn about Tuberculosis TB and infection control you. can help reduce or eliminate the spread of TB in homeless shelters Homeless shelters provide. an important safety net for homeless people and are an important player in ensuring that. homeless people are in the healthcare system As an employee of a shelter you work with clients who. face a variety of needs that include social physical mental and health challenges Although TB may. not be at the top of your priority list it is an important issue. TB outbreaks occur at homeless shelters throughout the United States because shelters are an ideal. setting for this airborne disease The spread of TB disease is affected by overcrowded living conditions. poor nutrition and lack of regular healthcare which puts homeless clients at risk for TB. You can create a healthy and safe environment for your clients and staff by reassuring them that TB. can be identified It is preventable treatable and it is curable You do not need to be afraid to work. with your clients or staff who may have TB You can do something about TB and prevent an outbreak. from happening at your shelter, S h e l t e r s a n d T B W h at S t a f f N e e d t o K n ow 2 nd Ed itio n 1. What is Tuberculosis TB,WHAT IS TB, TB is a disease caused by a bacteria or germ called Mycobacterium tuberculosis. It usually attacks the lungs but it can affect any part of the body. If TB is in the lungs it usually is contagious, It can cause sickness and even death if left untreated. With proper diagnosis and treatment TB is almost always curable. HOW IS TB SPREAD, The TB germ is spread through the air when someone with.
contagious TB coughs or sneezes Anyone nearby can, breathe in these germs and become infected Your chance. of catching TB is low if you are around that person for just a. short time Usually you have to be around them for awhile. and they have to be coughing a lot,WHAT ARE THE RISK FACTORS FOR TB. Healthy people who have TB infection may never develop TB disease About 10 of all people who. have TB infection will develop TB disease at some point during their lifetime The remaining 90 will. stay infected but free of disease for the rest of their lives However special medical conditions may. increase the risk for TB disease,Exposure Infection Disease. People exposed to TB People Infected People with active TB disease. About 10 of people infected or,higher if medical risks are present. For INFECTION For DISEASE, These are some factors that cause the spread of TB These are some factors that determine whether.
an infected person will develop active TB disease,Overcrowded living conditions HIV infection. Poor ventilation in living area Injection drug use. Repeated exposure to TB germ Malnutrition often seen in alcohol substance users. Recent TB infection within past 1 2 years,Diabetes or other health condition that weakens. immune system, WHAT S THE DIFFERENCE BETWEEN TB INFECTION AND TB DISEASE. It s important to know the difference between TB infection and TB disease just because someone. has TB infection does not necessarily mean they have TB disease. TB Infection also referred to as latent TB infection LTBI. TB infection occurs when you breathe in the TB bacteria into your body If your body s immune. system is able to prevent the TB germs from growing it will keep you healthy and although you. are infected you stay healthy, TB INFECTION needs to be medically treated and is not contagious at this stage. TB Disease, Infection can turn into disease when the TB bacteria becomes active and grows This often.
happens if your immune system breaks down or is compromised by a health condition such as. HIV diabetes injection drug use or poor nutrition Some people develop TB disease soon after. becoming infected before their immune system can fight the TB bacteria Other people may get. sick later when their immune system becomes weak, TB DISEASE can be contagious It is treatable and can usually be cured if the person is. diagnosed and receives medical treatment right away. S h e l t e r s a n d T B W h at S t a f f N e e d t o K n ow 2 n d Ed itio n 3. Is more likely to get disease,Has symptoms,Can infect other people. WHAT ARE THE CAUSES SIGNS AND SYMPTOMS FOR, TB Infection or Latent TB Infection LTBI TB Disease. You breathe TB germs into your body from the You breathe TB germs into your body from the coughing or. coughing or sneezing of someone who has TB disease sneezing of someone who has TB disease. You have positive TB test You have a positive TB test. You have a normal chest x ray You have an abnormal chest x ray or TB bacteria are. found in your cough or sputum, You have no symptoms You have symptoms that include. a cough that is not getting better after 3 weeks,pain in the chest.
coughing up blood or phlegm, feeling very tired for no reason lasting more than 2 weeks. weight loss without trying,no appetite,fever lasting more than 1 week. sweating at night, You can not spread TB to others You can spread TB to others if. you have TB disease in the lung, and you are not treated with antibiotics for TB disease. Chart adopted from Homeless Health Care Los Angeles and Centers for Disease Control and Prevention s Questions and Answers About TB 2002. HOW DO I KNOW IF I HAVE TB,For TB Infection, To find out if someone has TB infection a TB test can be taken Two types of tests are available the Mantoux.
tuberculin skin test TST or a blood assay test for Mycobacterium tuberculosis. The Mantoux tuberculin skin test TST is also known as PPD which stands for Purified Protein. Derivative This protein material is injected under the skin of a person s forearm It is read 48 72 hours later. by a trained healthcare provider If the skin test result is positive it means that the person has at some. time been infected with TB However it does not mean that the person also has TB disease. For the blood test there are two commercially available products to test for TB infection QuantiFERON TB. Gold In tube and T Spot The advantages of blood test compared with the Mantoux TST are that test results. can be obtained after a single patient visit and as results are automated there is less discrepancy in the. reading and interpretation of the result,For TB disease. To find out if someone has TB disease several additional steps are needed TB disease cannot be. detected with just one step The first step is to conduct a complete medical history physical exam and. symptom review of the person and then the following tests and exams are used. sputum phlegm samples,a chest x ray, S hel t ers a n d T B W h a t S t a f f Ne e d t o Kn o w 2nd Ed itio n 5. It is important to complete treatment to get well and prevent further spread of TB If patients with. TB disease do not complete treatment some of the TB germs will survive and usually cause TB at a. from watching the entire video A sample TB curriculum can be found in the Appendix section to help a trainer or facilitator plan a TB training Video Viewer s Guide shelter s TB infection control policy A Word About Recommendations Efforts have been made to ensure that this video and viewer s guide includes applicable recommendations from the Centers for Disease Control and Prevention

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