Alaska Tuberculosis Program Manual - Epidemiology - State of Alaska

Tuberculosis Discharge Planning Checklist for: (Name) _____________________________
Report all suspected or confirmed TB cases to the Alaska TB Program at 269-8000 during normal
business hours or after hours at 1-800-478-0084 within 5 working days of identification.
□ Physician:
__Medication/treatment information is available at: http://www.epi.hss.state.ak.us/bulletins/docs/rr2006_02.pdf
__Consultation for any suspected TB patient is available from the Alaska TB Program.
__Before discharge, the PHN case manager will need a prescription for TB meds. They will be supplied free of charge
and provided to the patient by directly observed therapy (DOT).
__Before discharge, patients traveling to rural areas will need a 1-2 week supply of TB medications to take home.
__Before discharge, patient will need a follow-up appointment for medical care.
□ Isolation needs:
__Airborne precautions (negative air flow room, respirator for staff, and proper signage on door) during hospital stay.
__Reinforce need to stay home until the public health nurse or clinician determines that isolation is no longer required.
__Do not discharge infectious patients to congregate settings such as, a nursing home, assisted living facility, shelter, or
correctional facility, unless they can be placed in airborne precautions to prevent exposing others.
□ Ensure patient is tolerating daily dosing of TB meds:
__Initiate 4-drug therapy; give all meds at the same time each day unless directed otherwise.
__Address any adverse reactions prior to discharge.
□ Educate the patient:
__Reinforce infection control measures to prevent transmission to others (i.e. remain in negative pressure room, avoid
contact with unexposed persons, cover mouth when coughing or sneezing, etc.).
__Collaborate with the local PHN to provide information about TB transmission, contact investigation, TB treatment,
adverse reactions, DOT, expected length of therapy, adherence to treatment, and the role of the PHN case manager.
□ Finalize discharge plan and arrange DOT with the Alaska TB Program and the PHN case manager at least 3 business
days prior to discharge:
__Fax the following to the Alaska TB Program at (907) 563-7868: H&P, TB medication administration records (MAR),
sputa and pathology results, labs (HIV, CBC, pertinent chemistry panels, liver function tests), chest x-ray and CT
reports, tuberculin skin test result (TST), estimated date of discharge, script for TB meds, and date of follow-up
appointment.
__Contact investigation is initiated as soon as possible for (+) AFB TB suspects and cases. Collaborate with the Alaska TB
Program and PHN case manager.
__If patient does not have safe, stable housing; make arrangements with the Alaska TB Program. Assess patient for
barriers that may impact treatment (i.e. substance abuse, no access to care/insurance, cultural beliefs, comorbidities,
etc.), and collaborate with PHN case manager to address them.
□ Travel needs:
__Consult with the Alaska TB Program to assure patient is cleared for commercial travel.
Notes:_____________________________________________________________________________________________
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□PHN Case Manager: _____________________________________ Phone: 907-___________ or _________________
□AK TB Program contact: __________________________________ Phone: 907-___________ or _________________
Rev 11/12