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Guidelines for the Prevention and Control of Influenza Outbreaks in Residential Care Facilities for Public Health Units in Australia

Appendix 9: Respiratory outbreak transfer notification

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To:

Please be advised that ________________________________________ is being transferred

from a facility where there is a

suspected

confirmed

influenza outbreak. Please ensure that appropriate infection control precautions are taken upon receipt of this resident.

At the time of transfer, this resident was

confirmed with

suspected of

had no symptoms of

influenza.

 

This resident has been vaccinated with the current influenza vaccine on ______date_________

This resident has NOT been vaccinated with the current influenza vaccine BECAUSE OF:

allergy

medication

conflict

conscientious objection

other ___________________________

 

Resident is taking the antiviral medication ________Name of Medication_______________________

Start date ______________________ Dose of the medication ________________________

For further information, contact __________Name of contact____________________ of

________Name of facility_________ on ________Phone number___________________

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Table of Contents
Guidelines for the Prevention and Control of Influenza Outbreaks in Residential Care Facilities for Public Health Units in Australia
  Disclaimer
  Acknowledgements
  Preface
  How to use this document
  Summary Flow Chart
  Chapter 1: Introduction
   1.1 Influenza
   1.2 Linkages with other documents and the internet
  Chapter 2: Preventing Outbreaks
   2.1 Vaccination
   2.2 Infection Control Precautions
  Chapter 3: Outbreak and Case Definitions
   3.1 Introduction
   3.2 Respiratory Disease Outbreak Definition
   3.3 Case definition
   3.4 Outcome definitions
  Chapter 4: Investigation and Management of Outbreaks
   4.1 Assess the Suspected Outbreak
   4.2 Outbreak Investigation and Management Team
   4.3 The Investigation
   4.4 Diagnostic tests
   4.5 Documents for communication with the facility
   4.6 Outbreak control measures
   4.7 Monitoring the outbreak
   4.8 Declare that the outbreak is over
   4.9 Debriefing
  Chapter 5: References
  Appendices
   Appendix 1: Environmental Cleaning
   Appendix 2: Respiratory Outbreak Control Measures
   Appendix 3: Checklist for Public Health Unit for Investigation and Management of Outbreaks
   Appendix 4: Respiratory Outbreak Line Listing - Residents ONLY
   Appendix 5: Part A Respiratory Outbreak Line Listing Form - Staff ONLY
   Appendix 6: Influenza & Pneumococcal Immunisation Survey
   Appendix 7: Sample Collection Guide*
   Appendix 8: Guidelines for Taking Nasal and Throat Swabs
   Appendix 9: Respiratory outbreak transfer notification
   Appendix 10: Visitor Restriction Sign - Facility
   Appendix 11: Visitor Restriction Sign - Room
   Appendix 12: Antiviral medications for treatment and prophylaxis of influenza
   Appendix 13: Respiratory illness/Influenza outbreak alert letter to RCF Manager
   Appendix 14: Respiratory illness/Influenza outbreak alert letter to medical practitioner
   Appendix 15: Glossary and List of Abbreviations