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Table of Contents (Cont.)

Section E: Instructions and Forms

  • PHN Assessment Guidance and Printout ……………………………..

  • Community/Consumer Services Guidance and Printout ……………..

  • TB Class 3/5 Assessment Instructions and Form …………………….

  • TB Follow-up Instructions and Form …………………………………

Section F: Evaluation of Practice

  • Instructions for using Forms and Worksheets ………………………...

  • Attachments A-E ……………………………………………………...

  • Frequently Asked Questions ………………………………………….

  • Evaluation Forms

    • o

      Acute Communicable Disease

      • -

        Individual Case ……………………………………….

      • -

        Outbreak in a Health Care Facility …………………...

      • -

        Outbreak in a Non-Health Care Facility ……………...

      • o

        Lead Poisoning ………………………………………………..

      • o

        Newborn Screening …………………………………………...

      • o

        Sexually Transmitted Disease ………………………………..

      • o

        Sudden Infant Death Syndrome………………………………

      • o

        Tuberculosis

        • -

          Cases/Suspects………………………………………...

        • -

          Contact Follow-up: Individual ………………………..

        • -

          Source Case Finding in a Documented Converter ……

Section G: Appendix

  • Quad Council PHN Competencies …………………………………...

Section H: Best Practices

© 2007 LAC DPH - Public Health Nursing

E1-E5 E6-E7 E8-E19 E20-E22

F1-F4 F5-F9 F10-F11

F12-F16 F17-F21 F22-F26 F27-F31 F32-F36 F37-F41 F42-F46

F47-F52 F53-F57 F58-F62

G1-G10

vi

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