Public Health Nursing Practice Manual
Tuberculosis: Per Tuberculosis Control Program April 2003
Priority I - None Priority II - Within 24 Hours of Report:
Client who has a positive sputum smear for AFB, abnormal chest x-ray and/or signs and symptoms of communicable tuberculosis Class 5 receiving or not receiving anti-tuberculosis medications.
Newly diagnosed Class 3 (positive culture MTBC) not receiving anti-tuberculosis medication.
Client who has communicable tuberculosis (Class 3) or communicable tuberculosis suspect (Class 5) and has left the hospital against medical advice from a health care institution, i.e., hospital (follow up to be coordinated with PHI).
Client who misses a DOT dose.
Priority III - Within 2 Days of Report:
Client who has an urgent suspect radiograph (Class 5) and no clinical assessment has been done.
Client who has a smear positive for AFB (Class 5) and/or culture positive for MTBC (Class 3) who has
broken a clinic appointment. 3. All TB Class 3 & 5 patients who break their MD/ERN appointments.
Priority IV - Within 3 Days of Report:
Newly diagnosed Class 3 or Class 5 who is HIV positive.
Newly diagnosed Class 3 or Class 5 who is less than 6 years of age.
Newly diagnosed Class 3 who is multidrug resistant (INH and Rifampin).
Client who is hospitalized and has a positive sputum smear for AFB requiring a report of home situation.
Contact investigation for a newly diagnosed Class 3 or Class 5 who is assessed as higher risk to transmit.
Priority V - Within 7 Days of Report:
Newly diagnosed Class 3 or Class 5 who is not included in the above priorities including Alien Referral Class B1).
Contact investigation for a newly diagnosed Class 3 or Class 5 who is assessed as lower risk to transmit.
Client who is receiving treatment for latent tuberculosis infection (LTBI) for a high-risk medical condition and breaks a clinic appointment.
High-risk contact who breaks an appointment for the initial examination.
Documented converter who breaks an appointment.
Priority VI - Within 14 Days of Report:
Class 5 – Alien Referral Class B2.
Source Case Finding for documented converters under the age of 4.
Source Case Finding for the age 4 and above, if resources allow and a reasonable probability of finding
Always consult the Tuberculosis Control Program Manual prior to action. Consult with PHN supervision with advice from the Area Medical Director, TB Clinic clinician and the TB Program Staff if there are questions about the priority of action.
© 2007 LAC DPH - Public Health Nursing