Get the free Pertussis Surveillance Worksheet, Appendix 11-508 compliant - wwwn cdc

Pertussis Surveillance WorksheetAppendix 11NAME (Last, First)Hospital Record No. Address (Street and No.) CityCountyReporting Physician/Nurse/Hospital/Clinic/LabPhoneAddressZipDEM165PhoneDEM163PhoneDETACH

How to fill out pertussis surveillance worksheet appendix

How to fill out pertussis surveillance worksheet appendix

1. To fill out the pertussis surveillance worksheet appendix, follow these steps:
2. Start by providing the necessary information at the top of the worksheet, such as the patient's name, date of birth, and contact information.
3. Record the onset of symptoms date, as well as any known exposure to pertussis.
4. Note the vaccination history of the patient, including dates and types of pertussis vaccines received.
5. Document the clinical presentation of the illness, such as the presence of cough, duration, and severity of symptoms.
6. Include any laboratory testing performed, such as PCR or culture results.
7. Provide information on any treatment received by the patient, including antibiotics and duration.
8. Finally, complete the worksheet by providing any additional relevant information or comments.
9. Remember to ensure the accuracy and completeness of the information entered in the worksheet.

Who needs pertussis surveillance worksheet appendix?

1. The pertussis surveillance worksheet appendix is typically needed by healthcare professionals, such as doctors, nurses, and epidemiologists, involved in the surveillance and monitoring of pertussis cases.
2. It is used to collect standardized information about pertussis cases, which helps in tracking the spread of the disease, identifying patterns, and informing public health interventions.

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What is pertussis surveillance worksheet appendix?

The pertussis surveillance worksheet appendix is a document used to track and monitor cases of pertussis, also known as whooping cough.

Who is required to file pertussis surveillance worksheet appendix?

Healthcare providers and public health agencies are required to file the pertussis surveillance worksheet appendix.

How to fill out pertussis surveillance worksheet appendix?

The pertussis surveillance worksheet appendix is typically filled out by entering patient information, symptoms, test results, and treatment history.

What is the purpose of pertussis surveillance worksheet appendix?

The purpose of the pertussis surveillance worksheet appendix is to collect data on pertussis cases in order to monitor and control the spread of the disease.

What information must be reported on pertussis surveillance worksheet appendix?

Information such as patient demographics, laboratory test results, vaccination history, and treatment details must be reported on the pertussis surveillance worksheet appendix.