Annex 6. A standardized checklist for periodic evaluation of TB infection prevention and control

This checklist is based on one produced by Médecins Sans Frontières (1).

Instructions: This tool provides an idea of the risk of transmission of M. tuberculosis in a health-care facility or congregate setting. The results should be completed by the IPC focal person and interpreted by the IPC committee. For the Yes/No questions, a Yes answer indicates good TB IPC practices. Any pertinent information on No answers is noted in the Comments section below each table.

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Obtain a scale drawing of the floor plan of the whole facility, including doors and windows. If this is not available, make a sketch. Shade the different areas according to the level of risk according to environmental measures:

  • high risk of TB transmission – dark grey
  • limited risk of TB transmission – grey
  • low risk of TB transmission – white

Include patients, staff flow and environmental measures (e.g. ventilation fans and germicidal ultraviolet fixtures).

Comments________________________________________________________________________________________

 

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Conclusions

Debrief the health facility manager after completing the assessment.

According to the assessor and the facility manager, what are the current main issues and barriers in implementation of TB IPC?

___________________________________________________________________________________________________
___________________________________________________________________________________________________

According to the assessor and the facility manager, what are the priority actions for TB IPC in this facility within the next 6–12 months?

Reference

1. Varaine F, Rich M. Basic TB infection control risk assessment tool. In: Tuberculosis. Paris: Médecins Sans Frontières, Partners In Health; 2023 (https://medicalguidelines.msf.org/sites/default/files/TB-Appendix%2B16.pdf, accessed on 11 September 2024).

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