Two Step Tuberculosis (TB) Screening Policy

p Patient's Name (rint)
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Two Step Tuberculosis (TB) Screening Policy
Two Step TB Screening Policy
All home visiting personnel are required to have an initial two step TB screening or a chest x-ray at the time of employment. Two step tuberculin skin testing is done to detect delayed hypersensitivity reactions in people who have been infected with mycobacterium tuberculosis. If the first test reading is positive, no further skin testing is done. The person would then require follow-up by their health care provider including a chest x-ray to rule out active disease and evaluation for appropriate medication and follow-up therapy. If the first test reading is negative, the second test is performed 1-3 weeks later. If the second test is positive the person is classified as "previously infected" and cared for accordingly. Note: Documentation of the two step tuberculin skin test is required only once if the person continues to have annual skin testing.
Previous Positive TB Screening
For persons who have documentation of a previous positive PPD, no skin testing is performed and follow-up including health evaluation, symptom screening, and periodic chest x-rays is required per current CDC
guidelines. Symptom screening review is to be completed yearly.
Two Step Tuberculosis (TB) Screening
TB Skin Test: 5Tu/0.1 ml administered intradermally
Test #1
#1 Date

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Site
Signature

Clear
#1 Reading Date:

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mm induration:
mm erythema:
Results:
PositiveNegative
Reading Signature:

Clear
Test #2
#2 Date

MonthDayYear
Date
Site
Signature

Clear
#2 Reading Date:

MonthDayYear
Date
mm induration:
mm erythema:
Results:
PositiveNegative
Reading Signature:

Clear
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