Student Health Policy

 

A.

Subject:

PPD Skin Tests

B.

Effective Date:

January 14, 1999

C.

Approved:

January 14, 1999

D.

Issued by:

Murray, Chance, Turner

E.

Policy:

  

The timely and accurate interpretation of PPD skin tests is important for decision making regarding individual treatment recommendations. Medical decisions are made based on measuring the often-subtle degrees of induration within 1 mm of accuracy. It is therefore the policy at the University of Virginia Department of Student Health that a trained Health Professional will read PPD skin tests within the standard time frame of 48-72 hours, typically a Physician, Nurse or Health Department Representative. This policy will apply both to PPD's placed at other facilities as well as those placed at Student Health.

F.

Procedure:
    1. Classification of the TB reaction:
      1. The reaction to the Mantoux test will be read by a trained health care professional 48-72 hours after injection.
      2. The diameter of the area of induration around the site of injection will be measured transversely across the forearm perpendicular to the long axis. All reactions will be recorded in millimeters of induration. A positive reading (number of millimeters considered positive may vary based on patient characteristics via CDC guidelines) will indicate the need for a chest X-ray and referral to a Student Health Care Provider for appropriate recommendations. All positive reactions must be double read by two care providers.
      3. Health history and risk will be assessed for all students and health care workers with positive PPD reactions according to CDC recommendations located in the Core Curriculum on Tuberculosis.
      4. The student will be referred to the triage nurse when pre-entrance records report a positive PPD, a documented negative x-ray, but no indication of "prophylactic" treatment or medical records documenting an informed decision not to treat. It will then be their decision to refer the student to a care provider for consultation.
    2. Intervention: Preventive therapy for students found to be infected but without active disease will follow the guidelines in the Core Curriculum for the CDC as will treatment for those with active disease.

Reviewed and approved by the Associate Directors Committee