Form 57.75RR High Risk Inpatient Influenza Vaccination Monthly Monito

Record the number of patients for each category below for the month being reviewed.
*Facility ID# :
*Vaccination type: Influenza	*Month:		*Year:
Patient categories			Number of patients in each category
*1. Total # of patient admissions
2. Total # of patients previously vaccinated during current influenza season
*3. Total # of patients meeting high risk criteria previously vaccinated during current influenza season

 

File Type	application/vnd.ms-powerpoint
File Title	Slide 1
Author	CDC
Last Modified By	rfp9
File Modified	2007-07-26
File Created	2004-07-27