Tuberculosis (TB) Contact Follow-up Standard of Practice Evaluation Form: Individual
Circle appropriate period
Documentation reflects consideration of client’s needs in determining interventions and/or on-going revisions of the plan of care (p. C54).
Documents client understands the disease and transmission process
Initiates action for non-adherent client
Follows up with non-adherent client
Completes and submits H289 registration per PHN Practice Manual (pp. C54-C55).
Ensure that H304 Preventative Treatment Closure is dispositioned and submitted if indicated (p. C55).
Follows-up on referrals as reported by client (p. C53).
© 2007 LAC DPH-Public Health Nursing