Acute Communicable Diseases Standard of Practice Evaluation Form: Outbreak in a Non-Healthcare Facility/Agency
Circle appropriate period
Documents specific plan that is selected from the PHN Practice Manual (pp. C16-C18).
Completes and documents disease and health event investigation per PHN Practice Manual
Interviews for source (p. C18).
Documents health teaching/counseling (p. C18).
Refers facility administrator or designee as
needed (p. C18).
Conducts surveillance of client as indicated
C18). (Surveillance describes & monitors health events through ongoing & systematic collection, analysis, and interpretation of health data).
© 2007 LAC DPH-Public Health Nursing