Emergency Plan
Same month every year (annually)
Complete the Agreement with another Agency. (Fax to us the information to complete/submit the Plan)
(only if the community served is under apandemic)
Same month every year (annually)
Complete the Agreement with another Agency. (Fax to us the information to complete/submit the Plan)
The following templates, must be used for the Agency Pandemic Management Plan documentation
Pandemic Management Plan: Mask Use guidelines
Emerging Infectious Disease (EID) report
EID Report (forward copy to Board of Director & Infection Prev. Committee - monthly)
Preventing Nosocomial Infections: Preventing Nosocomial Infections (monthly)
Pandemic Management Plan Compliance Report (Infection prevention) Pandemic Infec. Prev. Report Monthly
Pandemic Log Control: Patients Staff
Pandemic Agency Actions Pandemic Response Roles
Pandemic Actions Pandemic Roles
Pandemic Infection Prevention Pandemic Home Care Planning
Pandemic Infection Prev. Pandemic Agency HC planning report
CDC Infection prevention recommendation CDC video
Disclaimer: Every template is only your guide to complete Pandemic Management Documentation, your Agency Officials must assure that task were completed, the quorum is acceptable, and every member had active participation in the discussion, activities.
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