Form 57.75TT Laboratory-identified MDRO Event Summary Form
The National Healthcare Safety Network (NHSN)
TT_LIMESummary.ppt
Laboratory-identified MDRO Event Summary Form
OMB: 0920-0666
                        ⚠️ Notice: This form may be outdated. More recent filings and information on OMB 0920-0666 can be found here:
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pdf| *Facility ID:
 | __________
 | *Month:
 | _____
 | *Year:
 | _______
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| *Are you reporting data for every bedded patient care location  of the facility? ____Y ____N
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| *Location
 | *Patient Days
 | *Admissions
 | 
| ________________
 | ________________
 | _______________
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| ________________
 | ________________
 | _______________
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| ________________
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 | _______________
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 | _______________
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 | _______________
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 | _______________
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| ________________
 | ________________
 | _______________
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| ________________
 | ________________
 | _______________
 | 
| Total:
 | ________________
 | _______________
 | 


 
| File Type | application/vnd.ms-powerpoint | 
| File Title | Slide 1 | 
| Author | Jasie L. Jackson | 
| Last Modified By | rfp9 | 
| File Modified | 2007-07-26 | 
| File Created | 2007-04-03 |