Get the free INFECTION CONTROL TRANSFER FORM - cdph.ca.gov - cdph ca

INFECTION CONTROL TRANSFER FORM Affix any patient labels here. This form should be sent with the patient/resident upon transfer. It is NOT meant to be used as ...

How to fill out infection control transfer form

How to fill out an infection control transfer form:

1. Start by gathering all the necessary information. This includes the patient's personal details such as their name, age, address, and contact information.
2. Next, ensure that you have the patient's medical history and any relevant medical records. This may include previous diagnoses, treatments, medications, and allergies. It is crucial to accurately document this information to ensure proper infection control measures can be taken.
3. When filling out the form, provide specific details about the infection or condition that the patient has. Include information on its severity, symptoms, and any visible signs.
4. If there are any precautions or special instructions regarding the transfer of the patient, make sure to note them on the form. This could include using isolation precautions, ensuring adequate hand hygiene, or wearing personal protective equipment.
5. Additionally, record any laboratory test results or diagnostic imaging findings that are pertinent to the patient's condition. These findings can aid in effective infection control management and treatment decisions.
6. Finally, ensure that the form is signed and dated. This validates the information provided and serves as a legal document for any transfers or handovers of the patient's care.

Who needs an infection control transfer form:

1. Healthcare facilities and organizations that are involved in transferring or receiving patients from other facilities typically require an infection control transfer form. This can include hospitals, clinics, long-term care facilities, and rehabilitation centers.
2. Healthcare professionals, such as doctors, nurses, and allied health personnel, who are responsible for coordinating the transfer of patients should also have access to the form. This ensures that proper infection control measures are followed during the transfer process.
3. In some cases, patients themselves or their caregivers may be required to fill out an infection control transfer form if they are transferring between facilities or seeking specialized care.

Overall, an infection control transfer form is essential to ensure accurate communication and appropriate infection control measures are taken when transferring a patient from one healthcare facility to another.

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What is infection control transfer form?

The infection control transfer form is a document used to report the transfer of a patient with an infectious disease to another healthcare facility.

Who is required to file infection control transfer form?

Healthcare facilities and providers are required to file the infection control transfer form when transferring a patient with an infectious disease.

How to fill out infection control transfer form?

The form must be filled out with the patient's information, details of the infectious disease, transfer details, and contact information of the sending and receiving facilities.

What is the purpose of infection control transfer form?

The purpose of the form is to ensure proper infection control measures are taken when transferring a patient with an infectious disease to prevent the spread of the disease.

What information must be reported on infection control transfer form?

Information such as the patient's name, age, date of birth, diagnosis, isolation precautions needed, transfer date, sending and receiving facility information must be reported on the form.