ࡱ> '` #bjbj{P{P 4::W`Q`Q`Q`Q,Q1{S2S2S2S2Sudd dzzzzzzz$)}hVzf5d@udffz2S2Sziiif4&2S2SzifziiV4q@q2SS \֨`Qftq r{01{qx gqqd5ehieTedddzziddd1{ffff)|0 |0 Appendix 4  SHAPE \* MERGEFORMAT  Timeline From diagnosis to identifying household contacts 2 working days From diagnosis to appointments for household contacts 5 working days From diagnosis to identifying potential risk and informing HPU 1 week From diagnosis to risk assessment at the institution 2 weeks From diagnosis to incident plan 4 weeks From diagnosis to screening casual contacts 6-8 weeks From screening to initial report 2 days Screening to final report 8 weeks Incident plan check list for TB nurses: Following diagnosis of a new case:Yes NoDateComments1Have you completed nurses paperwork? (Yes ( No2Have you identified household contacts?(Yes ( No3Have you identified other significant contacts?(Yes ( No4Have you informed HPU of public health risks? (Yes ( No5Have Have you discussed risk assessment with HPUHPU?(Yes ( No6Who will carry out the risk assessment at the institution? 7Have you agreed on an incident plan?(Yes ( No8Is there going to be an incident control meeting? (Yes ( No9Have you agreed who will contact the institution? (Yes ( No10Have you agreed who should be screened? (Yes ( No11Have you agreed on screening date with HPU and the institution? (Yes ( No12Have you agreed screening method with HPU? (Yes ( No13Are additional resources needed for screening? (Yes ( No14Have you agreed on dealing with media? (Yes ( No15Have you agreed a time frame for communication of screening results between Clinic and HPU? (Yes ( No16When would the clinic provide the initial results?17When would the clinic provide the final results?18Have you agreed on communications with the PCT and other stakeholders?(Yes ( No19Have you sent 2nd appointment letters to DNAs?(Yes ( No20Are all those who screened positive referred to local TB service? (Yes ( No Incident plan check list for HPU: Following diagnosis of a new case:Yes NoDateComments1Is this a case of TB where there are public health implications? (Yes ( No2Does this involve an institution outside the reporting clinics area? (Yes ( No3If yes, have you informed the clinic covering the affected institution? (Yes ( No4Have you discussed risk assessment with clinic?(Yes ( No5Who will carry on the risk assessment? 6Have you agreed on an incident plan?(Yes ( No7Is there going to be an incident control meeting? (Yes ( No8Have you agreed who will contact the institution? (Yes ( No9Have you agreed who should be screened? (Yes ( No10Have you agreed on screening date with the clinic and the institution? (Yes ( No11Have you agreed screening method with the clinic? (Yes ( No12Are additional resources needed for screening? (Yes ( No13Have you agreed on dealing with media? (Yes ( No14Have you agreed a time frame for communication of screening results between Clinic and HPU? (Yes ( No15When would the clinic provide the initial results?16When would the clinic provide the final results?17Have you agreed on communications with the PCT and other stakeholders?(Yes ( No18Have you informed HPU communications team? (Yes ( No19For those contacts who did not attend for screening after two appointments, have you sent a letter copied to their GPs? (Yes ( No Patient identified with TB Any public health concerns? (See boxes 1 & 2) TB nurse to call HPU (reactive team) No TB clinic and HPU to agree on what action should be taken, e.g. incident meeting, letters by HPU, press release, using legal powers, meeting with PCT, LA, Occupational Health, etc. Enter on LTBR and complete nurses paperwork Yes Do not call HPU TB clinic to carry out household contact screening Box 1 Case(s) of infectious TB (sputum smear positive pulmonary TB), AND Index case(s) in the following settings: Passenger in a long-haul flight (>8 hrs) Inpatient in an open ward >8 hrs or contact with the immuno-suppressed Healthcare workers Cases in a educational settings (school, college, university) Cases in childcare settings Cases in prisons, hostels, residential or nursing homes or other similar settings Workplaces where there is considerable contact with colleagues Significant exposure in social settings , e.g. place of worship, clubs, pubs TB clinic and HPU to agree on who leads on the incident and roles (see box 3) Incident within the area? Yes No HPU to refer to relevant clinic/HPU Box 3 Organising Incident meeting if necessary: TB clinic, HPU Contacting place of incident and letters: HPU, senior TB nurse Communications with other stakeholders: HPU, chest clinic Assessment of workplace, school, hospital, etc: Senior TB nurse, hospital ICN Dealing with media, public: HPA/PCT hospital communications Inform clinicians: TB clinic, HPU Box 2 Other public health implications such as: non-compliant infectious cases/lost to follow up case do not provide details of close contacts or close contacts refuse screening source of infection unknown (e.g. TB in a child where all household contacts are clear) MDRTB Public anxiety, media attention, political implications Occupational health failure, SUIs Incident Plan Screening to be carried out as per incident plan Informing HPU that screening carried out or any major problems: in 2 days. Initial reporting of screening incl. 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