A separate template section is dedicated to laboratory
TB-IC, reflecting the specific issues and needs of laboratories
and the applicable TB-IC procedures. Thereafter
follows a section on M&E that includes indicators related to:
the implementation of the isolation policies, access of TB diagnostics
and follow up, training process and educational
activities, the risk of TB disease among staff, implementation
of environmental TB-IC measures, proper maintenance of
equipment and personal respiratory protection. This template
section also suggests how and with what frequency the indicators
should be monitored. The last template section e
budget e includes the recommended steps of a budget
development process, as well as examples of the most
important budget lines to be reflected in the facility budget
related to TB-IC. The template document highlights that each
facility needs to identify their own activities according to the
risk assessment and taking into account the (TB) IC measures
already in place.
The draft facility TB-IC plan template was discussed
extensively with the Romanian experts during a two-day
meeting using methods such as small group work, poster
presentations and plenary discussions. They provided
detailed feedback regarding the content, utility and applicability
of the template in Romanian facilities. Even the language
of the plan was adjusted, following the suggestion of
the experts, based on what they perceived to be more prescriptive
instruction and therefore more relevant for the
Romanian communication style. Afterwards the amended
facility TB-IC plan template was distributed to facilities,
whose representatives had attended the expert meeting. They
were asked to use the template for developing or updating the
facility TB-IC plan in their own facility or, in case they were
county TB coordinators, to promote it in the county.
After the development of the TB-IC plan template a halfday
Training of Trainers (TOT) and two-day TB-IC training
for key TB-IC providers were organized for 9 and 42 persons
respectively. The project team involved experts who could
influence TB-IC practices in the facilities and beyond: facility
supervisors, county managers and the coordinators of the
different departments inside the NTP. Both training events
were designed based on a training needs assessment among
the professionals in charge of TB-IC in the facilities. The
objective of the TOT was to build the capacity of the selected
trainers to be able to conduct TB-IC training for key providers
in the future. This was put to immediate use as the TOT attendees
co-facilitated group work at the training for key TB-IC
providers that was conducted right after the TOT. The training
materials were developed by the project team and they
focused on: a) improving knowledge, such as knowledge of the
local legislative acts applicable to TB-IC; and b) strengtheningpractical skills, such as the measurement of ultraviolet
germicidal irradiation (UVGI) and respirator fit-testing. In
addition, the TB-IC training for key providers was used as an
opportunity for the participants to discuss their progress and
achievements in developing their facility TB-IC plans and
implementing them, as the training took place two months
after the facility TB-IC plan template had been distributed to
the facilities. Finally, the training represented an opportunity
to talk about broader issues, which the participants encountered
while developing the TB-IC plans in their facilities,
discuss solutions, and identify a few common challenges to
TB-IC implementation in Romania which were encountered
by a number of facilities.