Inter-Facility Infection Control Transfer Form

Inter-Facility Infection Control Transfer Form - Cdc

INTER-FACILITY INFECTION CONTROL TRANSFER FORM

FOR STATES ESTABLISHING HAI PREVENTION COLLABORATIVES

This example Inter-facility Infection Control patient transfer form can assist in fostering communication during transitions

of care. This concept and draft was developed by the Utah Healthcare–associated Infection (HAI) working group and

shared with Centers for Disease Control and Prevention (CDC) and state partners courtesy of the Utah State Department

of Health.

This tool can be modified and adapted by facilities and other quality improvement groups engaged in patient safety

activities.

Inter-Facility Infection Control Transfer Form - Cdc