The administrative measures at a health care facility play an important role in preventing the spread of TB in health care settings. It includes Administrative controls for outpatient and inpatient settings
Administrative measures at Outpatient(OPD) settings
1. Screen for respiratory symptoms as early as possible upon patient’s arrival at the health care facility thereby reducing the overall stay of such patients in the healthcare facility
Ventilation is defined as the supply/ distribution/ exchange or removal of air from spaces by mechanical or natural means.
Mycobacterium tuberculosis is transmitted in airborne particles called droplet nuclei that are expelled when a person with pulmonary TB coughs, sneezes, shouts, or sings. People nearby may breathe in these bacteria and become infected.
Airborne infection control is essential to prevent the spread of TB within a health facility and other settings.
Hierarchy of Controls to Reduce Risk of Transmission of TB (see the Figure)
The Medical Officer (MO) of Designated Microscopy Centre (DMC) is responsible for determining the amount of reagents and other materials the DMC needs every month.
The Senior TB Laboratory Supervisor (STLS) will make sure these supplies are distributed in a timely manner, usually on a monthly basis or as and when required.
After air drying and heat-fixing of the smear, it needs to be stained.
Fluorescence microscopy (FM) staining should always be carried out in a designated area. The reagents required for the FM staining procedure are shown in Figure 1. The steps involved in the staining procedure are shown in Figure 2.
Figure 1: Reagents Required for FM Staining
Results of Ziehl–Neelsen (ZN) and Fluorescence Microscopy (FM) are added to Nikshay Diagnostic Module. After a patient is registered, test details are added which then leads to the page to add details on sample type, facility and test results (Figures 1-6).
Features of Nikshay Diagnostic Module
After air drying and heat-fixing of the smear, it needs to be stained for the identification of MTB during microscopy.
The reagents required for the ZN staining procedure are shown in Figure 1. The steps involved in the staining procedure are shown in Figure 2.
Figure 1: Reagents Required for ZN Staining
For sputum smear microscopy, the slides should be air-dried as heating the slide while the smear is wet can result in bubbling of TB bacilli into the air.
Fixation makes the sputum stick to glass slide and preserves the shape of the bacilli.
The procedure for air-drying and heat-fixing the slide is as follows:
Storage conditions of sputum sample can effect the test results.
Storage of Sputum Samples
For microscopy
The binocular microscope requires considerable care in its use, regular cleaning, and protection from dust and fungal growth.
Annual maintenance of a microscope includes: