Epidemiology Surveillance Laboratory Record - Department of Health (New Jersey)

Form Template

This epidemiology surveillance laboratory record for the Department of Health of New Jersey has been turned into an easy to use mobile application.

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Here is a sample entry. Please identify, list, and record antimicrobial susceptibilities (using CLSI guidelines) for the following Inpatient Blood Isolates: A. Gram positive cocci resistant to Vancomycin. B. Gram negative rods resistant (not intermediate) to Imipenem. C. Gram negative rods resistant to Amikacin, Gentamicin, or Tobramycin. D. Pneumococcal/Streptococcal isolates resistant to Penicillin. This application is easily modified to meet your labs needs.

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Dave Kramer, PennLine Service

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