Infection Tracking Log

Infection Tracking Log Facility Month/Year Date Name Access Symptoms Cultures-Organism Treatment Plan * Outcome & Date Redness Exit/Access site AV Fistula Hospitalized AV Graft Temp Blood Antibiotics Removal Tunneled catheter Drainage Organism identified: Infection resolved Non-tunneled catheter Pain PD catheter Other: Edema Redness Exit/Access site AV Fistula Hospitalized AV Graft Temp Blood Antibiotics Removal Tunneled catheter Drainage Organism identified: Infection resolved Non-tunneled catheter Pain PD catheter Other: Edema Redness Exit/Access site AV Fistula Hospitalized AV Graft Temp Blood Antibiotics Removal Tunneled catheter Drainage Organism identified: Infection resolved Non-tunneled catheter Pain PD catheter Other: Edema Redness Exit/Access site AV Fistula Hospitalized AV Graft Temp Blood Antibiotics Removal Tunneled catheter Drainage Organism identified: Infection resolved Non-tunneled catheter Pain PD catheter Other: Edema Redness Exit/Access site AV Fistula Hospitalized AV Graft Temp Blood Antibiotics Removal Tunneled catheter Drainage Organism identified: Infection resolved Non-tunneled catheter Pain PD catheter Other: Edema Redness Exit/Access site AV Fistula Hospitalized AV Graft Temp Blood Antibiotics Removal Tunneled catheter Drainage Organism identified: Infection resolved Non-tunneled catheter Pain PD catheter Other: Edema

*Record antibiotic given and total # of days of antibiotic treatment