During rounds, which observation would require intervention by the infection control nurse?

• A. Not wearing a mask when entering a client room with active TB
• B. Wearing a disposable surgical face mask when entering the room of a client with active pulmonary TB
• C. Reusing disposable masks between patients
• D. Removing PPE before exiting the room

Answer: (B)

TB is transmitted through airborne particles, so protecting healthcare workers requires airborne precautions with an N95 respirator that is properly fit-tested. A disposable surgical mask does not filter the small droplet nuclei that carry Mycobacterium tuberculosis, so entering a room with active pulmonary TB while wearing only a surgical mask is not adequate protection. This is why that observation would trigger infection control intervention to ensure the proper respirator is used and properly fitted. Other lapses, like not wearing any mask, reusing disposable masks between patients, or doffing PPE improperly, are also problematic, but the key issue here is the insufficiency of a surgical mask for airborne TB.