We repeat quantiferon testing for low positives. 0.35-1.0 in 1 month. If the second test is positive, then the patient is considered positive.  If the second test is less than 0.35, then the patient is considered negative.

For our indeterminate results, we repeat in 1 month. If the second test is also indeterminate, then we administer at skin test. If the patient has not had another skin test in the last year, then we do a 2 step. The boosted result will be more accurate.

Jayme Kasman RN, MSN

Employee Health Nurse
Barton Occupational Health

P. 775.589.8935  F. 775.589.8987

jkasman@bartonhealth.org

www.bartonhealth.org

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Today's Topics:

   1. Re:  TB screening  and indeterminates (Spangler, Mary)


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Message: 1
Date: Fri, 31 Mar 2017 17:29:37 +0000
From: "Spangler, Mary" <MSpangler@stanfordhealthcare.org>
To: MCOH/EH <mcoh-eh@mylist.net>
Subject: Re: [MCOH-EH] TB screening  and indeterminates
Message-ID:
        <DM5PR01MB2700B67E4913C474B40AC4CECD370@DM5PR01MB2700.prod.exchangelabs.com>

Content-Type: text/plain; charset="utf-8"

We are also doing more skin tests these days.

Mary



Take 3 minutes to watch this doodle on sharps safety.  https://www.youtube.com/watch?v=mpm_7pNn5GM&feature=youtu.be

Mary Spangler, M.S., N.P., COHN-S
Administrative Director, Occupational Health Services
Stanford Health Care & Stanford Children?s Health Care
300 Pasteur Drive, M/C 5205, Stanford, CA 94305-5513
Office: (650) 725-9583 Fax: (650) 498-7748 (fax)
mspangler@stanfordhealthcare.org<mailto:mspangler@stanfordhealthcare.org>
Administrative Assistant Michelle Fitch 650-725-2529   mfitch@stanfordhealthcare.org<mailto:mfitch@stanfordhealthcare.org>
[logo sig.png]                        [Stanford Children Health]
Confidential Information: This communication and any attachments may contain confidential or privileged information for the use by the designated recipient(s) named above. If you are not the intended recipient, you are hereby notified that you have received this communication in error and that any review, disclosure, dissemination, distribution or copying of it or the attachments is strictly prohibited. If you have received this communication in error, please contact me and destroy all copies of the communication and attachments. Thank you.

From: MCOH-EH [mailto:mcoh-eh-bounces@mylist.net] On Behalf Of Thrasher, Terri
Sent: Friday, March 31, 2017 9:23 AM
To: MCOH/EH <mcoh-eh@mylist.net>
Subject: Re: [MCOH-EH] TB screening and indeterminates

I place a ppd at the same time I repeat the QFT

From: MCOH-EH [mailto:mcoh-eh-bounces+terri.thrasher=cchmc.org@mylist.net] On Behalf Of Tara Dockery
Sent: Friday, March 31, 2017 12:12 PM
To: MCOH/EH <mcoh-eh@mylist.net<mailto:mcoh-eh@mylist.net>>
Subject: Re: [MCOH-EH] TB screening and indeterminates

For our borderline we had one that was retested in a week, as per the protocol on the reference lab result, and it came back as borderline again. This was expensive, and time consuming. To remedy the situation we did a Mantoux PPD and that came out negative.

When we had an indeterminant employee (seemed to mention they may have had a low lymphocyte count??) rather than retesting the employee because she mentioned she had been taking a new kind of vitamin and supplement, so presuming the employee was healthy and we didn?t want to look into her lymphocyte count and open a can of worms, we decided there could have been an interfering substance and decided to use the old Mantoux skin test PPD, which also came back negative for her.

So in both scenarios, to save time and money, I do believe in the future we will back up with a Mantoux PPD.


This is what I found to work for us
Tara



Tara Lee Dockery, IP, MT(ASCP), BS
Infection Prevention and Employee Health

Ocean Beach Hospital and Clinics
174 First Avenue North
Ilwaco, Washington 98624

tdockery@oceanbeachhospital.com<mailto:tdockery@oceanbeachhospital.com>
Office Phone  360 ? 642 - 6307
Cell Phone 509-760-7397
Fax  360-642-6309



From: MCOH-EH [mailto:mcoh-eh-bounces@mylist.net] On Behalf Of Yvonne Noel
Sent: Friday, March 31, 2017 8:41 AM
To: MCOH/EH <mcoh-eh@mylist.net<mailto:mcoh-eh@mylist.net>>
Subject: [MCOH-EH] TB screening and indeterminates

If you are using the  Quaniferon Gold test, would you mind sharing your reference ranges?  If you have set up a borderline or indeterminate reference range, can you tell me how individuals who test in this range  are managed, e.g. repeat testing in two months.


[cid:image019.png@01D01A13.D55BFA20]<https://urldefense.proofpoint.com/v2/url?u=http-3A__www.childrens.com_&d=DwMGaQ&c=P0c35rBvlN7D8BNx7kSJTg&r=Jmg5o1TWVLt02_ZQHrHWz9cq2GUFrnmW1sIeobramoY&m=dnPaBJHqvYDZPD0PztdjO7tEYH2q5qe217Yftqn64bw&s=LHRUoprRdD5vHk8J9Af385AiQYsbPE2_-OjpRaFnowI&e=>

Yvonne Noel, RN, COHN-S, CIC
Manager
Occupational Health & Wellness
O: 214.456.8983
F: 214.456.2665
E: mary.noel@childrens.com<mailto:mary.noel@childrens.com>


1935 Medical District Drive | Mailstop BL.100 | Dallas, TX 75235

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