TB Skin Test Two-Step Tracking
Track two-step TB skin test or IGRA completion for healthcare workers at hire and on annual follow-up. This template helps you verify timing, results, follow-up, and recordkeeping in one audit trail.
Trusted by frontline teams 15 years of frontline software AI customization in seconds
Built for: Hospitals And Health Systems · Long Term Care And Assisted Living · Outpatient Clinics · Home Health Agencies
Overview
This template is for tracking employee TB screening records when your program uses a two-step tuberculin skin test or an IGRA for baseline and follow-up surveillance. It is built to confirm the worker is assigned to the correct record, the screening method is documented, the dates are in the right sequence, and the result is supported by lab or clinic documentation.
Use it at hire or onboarding, during annual surveillance, and after any positive, indeterminate, or otherwise abnormal result that needs follow-up. The two-step TST section is especially useful when you need to verify the first placement and read, the second placement after the required interval, and the second read within the correct window. The IGRA section captures the result and interpretation when blood testing is used instead of skin testing.
Do not use this template as a general employee health file or for unrelated immunization tracking. It is not meant for casual symptom checklists, vaccine records, or ad hoc notes without dates and supporting documentation. It works best when your facility has a defined TB screening policy, a clear surveillance interval, and a designated reviewer in occupational health or employee health. If a worker has a prior positive TB test, a documented exemption, or a medical reason to use an alternative pathway, the template should record that rationale rather than forcing a standard two-step sequence.
Standards & compliance context
- This template supports occupational health documentation practices commonly used under OSHA general industry recordkeeping and medical surveillance programs.
- The two-step TST timing fields help align with healthcare TB screening practices referenced in public health and occupational medicine guidance.
- The follow-up and interpretation fields support provider review expectations when a test is positive, indeterminate, or requires symptom evaluation.
- The recordkeeping section helps preserve source documentation in a format that can be reviewed during compliance audits or internal quality checks.
- If a work-related TB infection is suspected, the record should be available for OSHA injury and illness log review and internal case management.
General regulatory context for orientation only — verify current requirements with counsel or the relevant agency before relying on this template for compliance.
What's inside this template
Employee Screening Record
This section matters because it ties the screening result to the correct worker and confirms the record is complete enough to audit.
- Employee TB screening record is present and assigned to the correct worker
- Screening type documented as two-step TST or IGRA
- Screening date documented
- Screening status documented
Two-Step TB Skin Test Timing
This section matters because two-step TSTs fail compliance if the placement and read dates are out of sequence or outside the required windows.
- First TST placement date documented
- First TST read date documented within the required reading window
- Second TST placement date documented and performed after the required interval
- Second TST read date documented within the required reading window
- Induration result documented for each TST step
IGRA / Result Interpretation
This section matters because a test result alone is not enough without interpretation and follow-up for positive or indeterminate findings.
- IGRA result documented when applicable
- TB screening interpretation documented
- Positive or indeterminate result has documented follow-up
- Follow-up evaluation includes symptom review and referral as needed
Annual Surveillance and Hire Compliance
This section matters because it shows whether baseline onboarding and recurring surveillance were completed on time or properly deferred.
- Baseline TB screening completed at hire or onboarding
- Annual follow-up TB screening completed when required
- Annual screening date is within the required surveillance interval
- Any deferral, exemption, or alternative testing rationale documented
Documentation and OSHA Recordkeeping
This section matters because source reports, provider review, and retention details are what make the record defensible during an audit.
- Laboratory or clinic report attached for each completed test
- Provider or occupational health review documented
- Work-related TB infection, if applicable, is documented for OSHA 300 Log review
- Record is complete, legible, and retained per policy
How to use this template
- Create a record for each worker and verify the name, job role, department, and screening method are matched to the correct employee.
- Enter the baseline screening type, then document whether the worker is completing a two-step TST or an IGRA under your facility policy.
- Record each placement and read date, confirm the read occurred within the required window, and capture the induration measurement for each TST step.
- Document the interpretation, attach the laboratory or clinic report, and note any positive, indeterminate, or follow-up-required result.
- Review annual surveillance dates, flag overdue follow-up, and document any deferral, exemption, or alternative testing rationale before closing the record.
Best practices
- Verify the worker identity before entering results so a screening record is never assigned to the wrong employee.
- Record the exact placement and read dates for each TST step, because a correct result with incorrect timing is still a deficiency.
- Capture induration in millimeters for each skin test step instead of using vague pass/fail language.
- Attach the source report from the clinic or laboratory at the time of entry, not after the audit is underway.
- Document the reason for any positive or indeterminate result and the follow-up disposition in the same record.
- Use a single surveillance interval rule across sites so annual screening does not drift by department or manager.
- Flag prior positive TB history, medical exemptions, or alternative testing pathways clearly so reviewers do not expect a repeat skin test.
What this template typically catches
Issues teams running this template most often surface in practice:
Common use cases
Frequently asked questions
Who should use this TB screening template?
Use it for healthcare employers, occupational health teams, and compliance staff tracking baseline and annual TB screening for employees with exposure risk. It is especially useful for onboarding nurses, aides, respiratory staff, and other workers covered by facility TB surveillance policies. If your site uses IGRA instead of a two-step TST for some workers, the template still works because it captures both pathways.
Does this template apply to both two-step TST and IGRA?
Yes. The structure is built to document either a two-step tuberculin skin test or an IGRA, then record the interpretation and any follow-up. That matters because some workers will need the two-step timing sequence, while others may be screened with a blood test under facility policy or provider direction. The template keeps both options in one record so you do not lose the screening method or result trail.
How often should TB screening be completed?
This template is designed for baseline screening at hire or onboarding and annual follow-up when your policy, risk assessment, or local requirements call for it. Some facilities only require annual screening for specific roles or after exposure events, so the cadence should match your written program. The key is to document the required interval and any reason a worker is deferred, exempted, or moved to an alternative test.
What counts as a complete record?
A complete record includes the worker assignment, screening type, dates, results, interpretation, and attached lab or clinic documentation. For a two-step TST, both placement and read dates should be present and within the correct windows, with induration documented for each step. If the result is positive or indeterminate, the record should also show follow-up evaluation and referral as needed.
What are the most common mistakes this template helps catch?
Common misses include a second TST placed too soon after the first, a read performed outside the required window, or a missing induration measurement. Another frequent issue is filing a result without the supporting lab report or provider review. The template also helps catch annual follow-up that is overdue or a screening record assigned to the wrong employee.
How does this relate to OSHA and recordkeeping requirements?
The template supports documentation practices aligned with occupational health recordkeeping and OSHA review expectations for work-related illness. It is not a substitute for your medical surveillance program, but it helps you show that screening, follow-up, and retention steps were completed and documented. If a work-related TB infection is suspected, the record should support OSHA 300 Log review and your internal incident process.
Can we customize this for different departments or risk groups?
Yes. Many organizations customize the template by unit, job class, exposure category, or onboarding workflow. You can add fields for fit testing status, symptom screening, prior positive history, or provider notes if those are part of your occupational health process. Keep the core timing and result fields intact so the audit trail stays consistent.
How should this be rolled out to clinics or multi-site facilities?
Start by standardizing the screening method, required interval, and who is responsible for review across sites. Then assign one owner for data entry and one reviewer for exceptions so records do not drift between HR, occupational health, and managers. If you use an EHR, HRIS, or spreadsheet workflow, map the same fields into each system so the documentation stays aligned.
Related templates
Ready to use this template?
Get started with MangoApps and use TB Skin Test Two-Step Tracking with your team — pricing built for small business.
