I have experienced Invalid testing with the Tspot, as well as borderline where they request a redraw. Unless the employee is willing to go through it again we tell them they have the option for the PPD or to be redrawn, because a couple times it was redrawn and they came back with the same result. I am not sure if its an interfering substance from vitamins or supplements people are taking, but the back up with the old Mantoux PPD has worked for us.

 

Tara

 

 

Tara Lee Dockery, IP, MT(ASCP), BS

Infection Preventionist and Employee Health Manager

Ocean Beach Hospital

174 First Avenue North

Ilwaco, WA 98624

 

Phone: (360) 642 - 6307

Fax : (360) 642 – 6309

 

tdockery@oceanbeachhospital.com

 

 

 

From: MCOH-EH [mailto:mcoh-eh-bounces@mylist.net] On Behalf Of Allen-Hardy, Blythe
Sent: Thursday, February 01, 2018 8:29 AM
To: 'MCOH/EH' <mcoh-eh@mylist.net>
Subject: Re: [MCOH-EH] TB Risk Status - Medium

 

Thanks Denece.

 

Description: https://secure1.mhhs.org/branding/CORPORATE_DOWNLOADS/USER_TEMPLATES/SYSTEM/email_signature/MHH_ESIGLogo.jpg

 

Blythe Allen-Hardy, MD, FACOEM

Medical Director, Employee Health

Texas Medical Center

6411 Fannin, JB500
Houston, Texas, 77030

W: 713-704-2792

C: 720-840-9593

F: 713-704-6350

Blythe.allen-hardy@memorialhermann.org

 

From: MCOH-EH [mailto:mcoh-eh-bounces@mylist.net] On Behalf Of Denece O Kesler
Sent: Thursday, February 01, 2018 8:45 AM
To: 'MCOH/EH'
Subject: [EXTERNAL] Re: [MCOH-EH] TB Risk Status - Medium

 

Dr. Allen-Hardy,

It may be your lab is the source of the invalid results, which I have seen with QFT results from a local lab.

 

Denece Kesler, MD, MPH

Medical Director

UNMH OHS

 

 

From: MCOH-EH [mailto:mcoh-eh-bounces@mylist.net] On Behalf Of Thrasher, Terri (Terri)
Sent: Thursday, February 1, 2018 6:06 AM
To: MCOH/EH <mcoh-eh@mylist.net>
Subject: Re: [MCOH-EH] TB Risk Status - Medium

 

Interesting we have very very few  invalids with QFT

 

From: MCOH-EH [mailto:mcoh-eh-bounces+terri.thrasher=cchmc.org@mylist.net] On Behalf Of Allen-Hardy, Blythe
Sent: Thursday, February 01, 2018 8:02 AM
To: MCOH/EH <mcoh-eh@mylist.net>
Subject: Re: [MCOH-EH] TB Risk Status - Medium

 

We are a large hospital system and test everyone for TB annually even contractors such as food service workers, etc. New-hires get T Spot. However, we have a high invalid result rate. Unsure why and need to look into this further since our lab processes them in house. Annually we administer the PPD. If the PPD has been previously positive, we administer a TB questionnaire and make sure they have a CXR on file. May look into quantiferon since we are seeing so many invalid t spot results.

 

Description: https://secure1.mhhs.org/branding/CORPORATE_DOWNLOADS/USER_TEMPLATES/SYSTEM/email_signature/MHH_ESIGLogo.jpg

 

Blythe Allen-Hardy, MD, FACOEM

Medical Director, Employee Health

Texas Medical Center

6411 Fannin, JB500
Houston, Texas, 77030

W: 713-704-2792

C: 720-840-9593

F: 713-704-6350

Blythe.allen-hardy@memorialhermann.org

 

From: MCOH-EH [mailto:mcoh-eh-bounces@mylist.net] On Behalf Of Thrasher, Terri (Terri)
Sent: Thursday, February 01, 2018 6:48 AM
To: MCOH/EH
Subject: [EXTERNAL] Re: [MCOH-EH] TB Risk Status - Medium

 

I am curious if others consider using T spot.  

A rep has contacted me and indicates the IDSA says T spot is superior and will only be 1 tube of blood and the new QFT has no pre analytics and requires 4 tubes.

 

Any thoughts on this to help me?

 

Kindest regards,

 

Terri

 

Terri L. Thrasher RN MSN

Sr. Director HR

Employee Health, Occupational Safety, Environmental Health, Employee Relations, Leave Management  HR Compliance/Policy, Workers Compensation, 803-SAFE, Injury Management, Non CCHMC Badging, Early Education and Childcare Center

3333 Burnet Ave

Cincinnati Ohio 45229  MLC 9006

513-636-6240

 

 

 

 

 

From: MCOH-EH [mailto:mcoh-eh-bounces@mylist.net] On Behalf Of Thanassi, Wendy
Sent: Tuesday, January 16, 2018 7:00 PM
To: MCOH/EH <mcoh-eh@mylist.net>
Subject: Re: [MCOH-EH] TB Risk Status - Medium

 

You’re welcome, any time. Here’s another slide for you.

 

Wendy

 

From: MCOH-EH [mailto:mcoh-eh-bounces@mylist.net] On Behalf Of Lisa Dyrdahl
Sent: Monday, January 15, 2018 9:33 AM
To: MCOH/EH <mcoh-eh@mylist.net>
Subject: [EXTERNAL] Re: [MCOH-EH] TB Risk Status - Medium

 

Wendy,

Thank you for this, it is most helpful especially with the citation for the guidelines. 

 

Thanks again!

 

Lisa Dyrdahl, RN, BSN

Employee Health Nurse

Lisa_Dyrdahl@Valleymed.org

Ph: 425-228-3440 X5720

Fax: 425-656-5066

 

From: MCOH-EH [mailto:mcoh-eh-bounces@mylist.net] On Behalf Of Thanassi, Wendy
Sent: Friday, January 12, 2018 12:31 PM
To: MCOH/EH <mcoh-eh@mylist.net>
Subject: Re: [MCOH-EH] TB Risk Status - Medium

 

Hello Lisa,

 

Yes, you can test some areas and not others.

 

The CDC 2005 and 2010 TB guidelines use the term “setting” for where annual TB testing should be done in medium and high risk areas. “Setting” allows that a huge hospital like ours would test certain areas, but not all people in all 102 building on all of our campuses. “Setting” is generally shared airspace, so if all 6 came through the medicine clinic, that area would become high risk but the O.R. would not.  (Of course shared airspace can be extended indefinitely to include the whole earth if one gets really energetic…) In sum, such surveillance should be undertaken in a reasonable manner to capture employees truly at risk for exposure but without wasting time, money and productivity hours chasing those who are not.

 

Newer guidelines will come out soon, and those are likely to be more flexible.

 

Wendy

 

Wendy Thanassi MA, MD

Chief, Occupational Health Service

Office of the Associate Director

Palo Alto VAHCS, California

650-493-5000 x 11-65214

 

Clinical Associate Professor

Stanford Hospital and Clinics

 

National Lead, Tuberculosis

Veteran’s Health Administration 10P4Z

Washington, DC

 

Description: Description: cid:image001.jpg@01CE4591.3F9AB100

Providing the best Occupational Medicine Care Anywhere—for VHA Employees and Veterans

VHAOccupationalEnviroMedConsult@va.gov  or https://vaww.portal.va.gov/sites/ohshg/OEMedicineConsults

 

From: MCOH-EH [mailto:mcoh-eh-bounces+wendy.thanassi=va.gov@mylist.net] On Behalf Of Deborah A. Pruim via MCOH-EH
Sent: Friday, January 12, 2018 9:08 AM
To: MCOH/EH <mcoh-eh@mylist.net>
Cc: Deborah A. Pruim <dpruim@lcmh.org>
Subject: [EXTERNAL] Re: [MCOH-EH] TB Risk Status - Medium

 

We are a low risk hospital.  We require annual screening (questionnaire) yearly for all employees.

All new hires are tested with a 2 step PPD at hire.  If they have had BCG we do a Quanteferon Gold test.

Thanks,

Debbie

Deborah Pruim, RN, MSN, APN, CNS

Employee Health Services

Little Company of Mary Hospital

2800 W. 95th Street

Evergreen Park, IL  60805

Monday – Friday

6:30am-3pm

Phone:  708-229-5623

Fax:  708-229-6618

dpruim@lcmh.org

cid:image001.png@01D2A32C.E73F4EA0

 

 

 

From: MCOH-EH [mailto:mcoh-eh-bounces@mylist.net] On Behalf Of Lisa Dyrdahl
Sent: Thursday, January 11, 2018 11:31 AM
To: MCOH/EH
Subject: [MCOH-EH] TB Risk Status - Medium

 

MCOH List Serve,

We have been a Low Risk hospital for TB and have not performed Annual testing since 2009.  We have now entered Medium Risk, (>6 patients with >200 beds).   According to the 2005 TB Prevention Guidelines we must now:

·         Test all HCWs on hire – (Which we have always done as Low Risk using QFG)

·         Test all HCWs at least every 12 months

·         Preform TB Symptom Screen for all HCWs with baseline negative results

 

My question for the list is whether we can test only High Risk Depts for TB or do we have to test all HCWs throughout the entire hospital?

 

Do we also need to provide symptom screening for everyone who test negative on baseline?  We currently do this for all Positive results only.

 

I had thought there was an option to either test all employees or only those in Hi Risk areas but I can’t find this documented. 

 

Thank you.

 

Lisa Dyrdahl, RN, BSN

Employee Health Nurse

Lisa_Dyrdahl@Valleymed.org

Ph: 425-228-3440 X5720

Fax: 425-656-5066

 

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DISCLAIMER: This message is confidential, intended only for the named recipient(s) and may contain information that is privileged or exempt from disclosure under applicable law. If you are not the intended recipient(s), you are notified that the dissemination, distribution or copying of this information is strictly prohibited. If you received this message in error, please notify the sender then delete this message.