Get Surgical Site Infection Form

Filling out the Surgical Site Infection Form online is a crucial step in monitoring and managing surgical site infections. This guide provides you with clear and detailed instructions to help you navigate each section of the form effectively.

Follow the steps to complete the form successfully.

1. Click the ‘Get Form’ button to obtain the form and open it in your preferred editor.
2. Complete the patient label section by entering the patient's birthdate, sex, admission number, and admission date.
3. Fill in the service or ward information, specifying where the patient received care.
4. For each surgical intervention, enter the date of operation, surgeon’s name, and operating room team members’ names.
5. Input the procedure code and NNIS category, then provide a detailed description using the ICD-9-CM format.
6. Select the wound class and indicate if the wound is contaminated or infected.
7. Enter the ASA score and the duration of the operation, including hours and minutes.
8. Indicate if the procedure was elective and whether laparoscopy or endoscopy was used.
9. Document the infection date and infection site, specifying the type of infection if applicable.
10. Specify if the infection was detected during admission or post-discharge along with any details on readmission or reintervention.
11. Record whether cultures were taken and provide details on microorganisms and specimen types.
12. Finally, fill in the date of discharge or death, and indicate the status at discharge.
13. Review all filled information for accuracy, then save, download, print, or share the completed form as needed.

Take action and complete your Surgical Site Infection Form online today!