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INTER-FACILITY INFECTION CONTROL TRANSFER FORM FOR STATES ESTABLISHING HAI PREVENTION COLLABORATIVES This example Inter-facility Infection Control transfer form transitions of care. Inter-facility Infection Control Transfer Form This form must be filled out for transfer to accepting facility with information communicated prior to or with transfer Please attach copies of latest culture reports with susceptibilities if available Sending Healthcare ...

How to fill out inter-facility infection control transfer

How to fill out inter-facility infection control transfer:

1. Start by gathering all relevant information about the patient who is being transferred, including their personal details, medical history, and the reason for transfer.
2. Ensure that you have the necessary forms or documents required for the transfer. These may include the inter-facility infection control transfer form, medical records, and any other relevant documentation.
3. Fill out the form accurately and completely. Provide all necessary information, such as the patient's name, age, address, and contact details. Include details about the transferring facility, receiving facility, and any additional healthcare providers involved in the transfer.
4. Specify the reason for the transfer, whether it is due to a specific infection or the need for specialized care. Include any relevant medical diagnoses, treatments, or medications.
5. Provide details about the infection control measures implemented at the transferring facility. This may include information about isolation precautions, immunizations, or other preventive measures taken to control the spread of infections.
6. Include information about the patient's current condition, including their vital signs, laboratory results, and any symptoms or complications of the infection. Document any recent changes in the patient's health status that may impact the transfer.
7. Ensure that all necessary signatures are obtained. This includes the signature of the transferring healthcare provider, the patient (if applicable), and any other authorized personnel involved in the transfer process.
8. Double-check all the information provided on the form for accuracy and completeness. If any additional documentation is required, attach it to the form.
9. Keep a copy of the completed inter-facility infection control transfer form for your records and submit the original to the receiving facility.

Who needs inter-facility infection control transfer:

Inter-facility infection control transfer is needed in situations where a patient requires transfer from one healthcare facility to another due to the presence of an infectious condition or the need for specialized care. This may involve transferring the patient to a higher level of care facility, such as from a community hospital to a tertiary care center, or from a long-term care facility to an acute care hospital. The transfer is necessary to ensure appropriate management and control of the infection, as well as to facilitate continuity of care for the patient.

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What is inter-facility infection control transfer?

Inter-facility infection control transfer refers to the process of transferring infectious patients safely and effectively between healthcare facilities while mitigating the risk of spreading infections.

Who is required to file inter-facility infection control transfer?

Healthcare facilities such as hospitals, clinics, and specialized care centers are required to file inter-facility infection control transfer.

How to fill out inter-facility infection control transfer?

To fill out inter-facility infection control transfer, healthcare facilities must gather relevant patient and infection control information, complete the designated transfer form, and submit it through the prescribed submission method.

What is the purpose of inter-facility infection control transfer?

The purpose of inter-facility infection control transfer is to ensure proper communication and coordination between healthcare facilities when transferring infectious patients, to prevent the spread of infections and protect patient safety.

What information must be reported on inter-facility infection control transfer?

Inter-facility infection control transfer typically requires reporting patient demographics, medical history, diagnosis, infectious disease status, treatment plan, precautions needed, and any relevant infection control measures.