Nursing Home Infection Control Log Template
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Nursing Home Infection Control Log
This log is to be used daily by staff to record all infection-related incidents within the facility. It should be filled out with accuracy to ensure proper tracking and management of infectious diseases.
Resident Information
Resident Name | Room No. | Age | Pre-existing Conditions |
|---|---|---|---|
[Resident Name] | 101 | 78 | Diabetes, Hypertension |
Incident Details
Time of Observation | Symptoms | Suspected Infection | Action Taken | Reported to (Name/Position) |
|---|---|---|---|---|
08:45 AM | Fever, cough | Yes - Flu | Isolation, Administered Antipyretic | Nurse Supervisor - [Name] |
Staff Health Screening
Staff | Position | Time In | Symptom Check | Temperature Check | Fit for Work |
|---|---|---|---|---|---|
[Name] | Nurse | 07:00 AM | No Symptoms | 98.6°F | Yes |
Sanitization Records
Area | Time | Staff Responsible |
|---|---|---|
Resident Rooms | 09:00 AM | [Name] |
Checked By: [Your Name]
Date: [Month, Day, Year]
[Your Company Name] commits to the health and safety of our residents and staff. This log is an essential part of our infection control measures. Please ensure all sections are completed daily.
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