ENQUÊTE PRÉVALENCE DES INFECTIONS 2017 - FICHE PATIENT / RÉSIDENT

LES DONNÉES DE CE QUESTIONNAIRE DOIVENT ÊTRE IMPÉRATIVEMENT ANONYMISÉES (AUCUN NOM DE PATIENT, AUCUN NOM D'ÉTABLISSEMENT NE DOIT ÊTRE RENSEIGNÉS)

    ES ET SERVICE / EMS

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    PATIENT / RÉSIDENT

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    SIGNES D'INFECTION

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    ANTÉCÉDENTS

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    FACTEURS DE RISQUE TRANSMISSION CROISÉE

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    PRÉLÈVEMENT(S)