Infection Prevention Manual

INFECTION CONTROL LOG: PATIENT INFECTIONS AT ADMISSION Month: ________ Year: _______ Date Pt ID# Infection MD Notified (Y/N) Antibiotic Tx Community Acquired Agency Acquired Infections to be Reported upon Admission: Infections to be Reported while on Service: 1. Chicken pox 1. Wound infections that develop 30 days or 2. German measles greater after admission which require an 3. Hepatitis B Antibiotic or identified by lab test or MD that 4. Small pox may or not may require antibiotic . 5. TB 2. Central-line associated bloodstream infections. 6. Any other reportable communicable disease 3. All infections associated with tubes and lines. as defined by the local health department. 4. All infections identified on the “Infections to be Reported upon Admission” listing. Report completed by (Name/Title): ______________________________________________________________ Your Agency Name (PN System)