Influenza Outbreak Investigation Report - Long-Term Care

Inspection template for documenting an influenza outbreak investigation in a long-term care facility, including onset timeline, case identification, resident isolation, reporting, control measures, and corrective actions.

Investigation Identification

• Facility name and unit/wing affected
• Investigation start date and time
• Investigation lead and role
• Outbreak status
• Reference document or case log link
  Enter the internal outbreak log, line list, or SOP reference used for this investigation.

Onset Timeline and Case Identification

• First resident symptom onset date and time
• First staff symptom onset date and time
• Total suspected resident cases
• Total confirmed resident cases
• Total suspected staff cases
• Case line list completed and attached

Resident Isolation, Cohorting, and PPE

• Symptomatic residents isolated or placed on transmission-based precautions
• Cohorting plan implemented for affected residents
• PPE available at point of care for staff entering affected areas
• Staff observed using appropriate PPE for droplet precautions
• Hand hygiene supplies accessible at unit entrances and resident care areas
• Visitor restrictions or screening implemented for affected unit

Testing, Treatment, and Clinical Coordination

• Influenza testing performed for representative cases
• Testing method used
• Antiviral treatment or prophylaxis initiated per facility protocol
• Medical director or attending clinician notified
• High-risk residents identified and monitored

Reporting, Environmental Controls, and Closure

• Local or state health authority notified
• Environmental cleaning and disinfection intensified in affected areas
• Staff and resident education provided on influenza symptoms and precautions
• Corrective actions documented and assigned
• Closure criteria met