Get the free 14-104 Needle Stick Injury

NEEDLE STICK INJURY Directive: 14 104 Date of Issue: July 2013 Amends/Cancels: 14117 I. PURPOSE The purpose of this Directive is to minimize potential exposure and to safely and effectively manage

How to fill out 14-104 needle stick injury

1. Gather all necessary information: Before filling out the 14-104 needle stick injury form, ensure that you have all the relevant details about the incident. This includes the date and time of the needle stick injury, the location where it occurred, and any other pertinent information such as the type of needle involved.
2. Fill out the personal details section: Begin by providing your personal information on the form. This typically includes your full name, contact information, and employee or identification number if applicable. Make sure to fill in all the required fields accurately.
3. Describe the needle stick incident: In the next section of the form, provide a detailed description of the needle stick injury. Include information about how and where the injury occurred, any witnesses present, and the specific circumstances surrounding the incident. Be as specific and thorough as possible to ensure proper documentation.
4. Indicate the severity of the injury: The form may have a section where you can indicate the severity of the needle stick injury. This could include options such as minor, moderate, or major. Select the appropriate option based on the extent of the injury.
5. Provide information about medical treatment: If you sought medical treatment following the needle stick injury, provide details about the healthcare provider you visited, the date and time of the visit, and any treatments or medications you received. Attach any relevant medical documents or reports if required.
6. Mention any post-exposure prophylaxis (PEP): If you were recommended or prescribed post-exposure prophylaxis (PEP) as a precautionary measure, make sure to include this information on the form. State the type of medication prescribed, dosage, and duration of treatment if known.
7. Witness statements: If there were any witnesses to the needle stick injury, ask them to provide a statement detailing their account of the incident. Their statements can support your claim and provide additional evidence.

Who needs 14-104 needle stick injury?

1. Healthcare workers: Healthcare professionals, including doctors, nurses, technicians, laboratory staff, and other medical personnel are likely to require the 14-104 needle stick injury form. This form is necessary for documenting and reporting needle stick injuries that occur during the course of their work.
2. First responders: Paramedics, firefighters, police officers, and other first responders who may come into contact with needles or sharp objects are also likely to need the 14-104 needle stick injury form. These individuals face potential exposure to bloodborne pathogens and need to report any needle stick injuries promptly.
3. Laboratory employees: Workers who handle needles, syringes, or other sharp instruments in laboratory settings may also require the 14-104 needle stick injury form. Accidental needle sticks can occur during the handling or disposal of such equipment, and it is essential to document these incidents for proper reporting and follow-up.
4. Other at-risk professions: Certain professions outside of healthcare and emergency response may also encounter needle stick injuries. This can include custodial staff, waste management workers, and individuals involved in needle exchange programs. If needle stick injuries are a potential hazard in these occupations, the 14-104 form may be necessary for reporting incidents and ensuring appropriate support and medical attention.

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What is 14-104 needle stick injury?

The 14-104 needle stick injury is a form used to report needle stick injuries that occur in the workplace.

Who is required to file 14-104 needle stick injury?

Healthcare providers, laboratory workers, and other employees who are at risk of needle stick injuries are required to file the 14-104 form.

How to fill out 14-104 needle stick injury?

The 14-104 form should be filled out with details of the needle stick injury, including the date, time, location, and circumstances of the incident.

What is the purpose of 14-104 needle stick injury?

The purpose of the 14-104 needle stick injury form is to ensure that all needle stick injuries are properly documented and reported, and to help prevent future incidents.

What information must be reported on 14-104 needle stick injury?

The 14-104 form should include information about the employee who was injured, the type of needle or sharp object involved, and details of the injury.