Tuberculosis (TB) Cases and Suspects Standard of Practice Evaluation Form
Circle appropriate period
Documentation reflects consideration of client’s needs in determining interventions and/or on-going revisions of the plan of care (p. 46).
Documents client understands the disease process and prevention of transmission (p. C46).
Initiates action for non-adherent client (p. C46).
Follows up with non-adherent client (p. C46).
Completes and submits H290 registration per PHN Practice Manual (p. C47).
Completes and submits H290 confirmation per PHN Practice Manual (p. C47).
Submits H513 closure per PHN Practice Manual (p. C47).
© 2007 LAC DPH-Public Health Nursing