Alaska Tuberculosis Program Manual - Epidemiology - State of Alaska

Whenever possible, start the initial assessment within one business day of the case
report for infectious or smear positive pulmonary cases; and within three business days
of the case report for others. Itinerants who provide TB case management for patients in
remote villages should initiate assessments as soon as possible. See MMWR
Guidelines for the Investigation of Contacts of Persons with Infectious Tuberculosis.
http://www.cdc.gov/mmwr/pdf/rr/rr5415.pdf
Hospital Discharge Planning
Patients with suspected or diagnosed active TB require collaborative discharge planning
before release. The case managers should ensure that appropriate discharge planning
occurs for all patients with TB, to prevent transmission in the community and interruption
in treatment. 15
Patients being considered for discharge should meet the following three criteria:
Complete at least 2 weeks of adequate treatment with anti-TB drugs
Demonstrate clinical improvement in TB symptoms; and
Have three (3) consecutive negative AFB sputum smear results collected in 8 –
24 hour intervals (at least one being an early morning specimen). 16
Hospitals should notify the Alaska TB Program at least 72 hours (3
business days) before discharging a patient with tuberculosis.
Hospital discharge planners should use the Tuberculosis Discharge
Planning Checklist (18.1) to coordinate discharge planning with the
Alaska TB Program and local PHNs. Send a copy of the pertinent medical
records to the Alaska TB Program or local PHN, as requested.
Initial Assessment Activities
To complete an initial assessment, perform the following activities:
Visit the patient’s home, hospital room or other location
If a face-to-face encounter cannot occur, make initial contact with the patient as
discussed in the “Assessment Site” topic of this section 10.7.
Obtain or review demographic information
A L A S K A T B P R O G R A M M A N U A L Case Management 10. 8
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