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This form is used by employees of the National College of Natural Medicine to report an incident of potential exposure to infectious bodily fluids and to consent for blood testing related to that

How to fill out bloodborne pathogen post-exposure incident

How to fill out Bloodborne Pathogen Post-Exposure Incident Form

1. Begin by obtaining the Bloodborne Pathogen Post-Exposure Incident Form from your workplace's safety or HR department.
2. Fill out the date and time of the exposure incident accurately.
3. Provide detailed information about the exposure, including the type of exposure (e.g., needle stick, splash) and the source of the potential infection.
4. Include the names and job titles of those involved in the incident, as well as any witnesses present.
5. Describe any immediate actions taken following the exposure, such as washing the site or seeking medical attention.
6. Document the incident with relevant details, including the location of the exposure and the procedures occurring at the time.
7. Sign and date the form to verify the information is accurate and complete.
8. Submit the completed form to the appropriate authority in your organization, such as your supervisor or safety officer.

Who needs Bloodborne Pathogen Post-Exposure Incident Form?

1. Individuals who have been exposed to blood or other potentially infectious materials in the workplace.
2. Employees working in healthcare settings, emergency response, or any environment where exposure to bloodborne pathogens is possible.
3. Supervisors and safety officers responsible for following up on exposure incidents.

People Also Ask about

What is the correct sequence of response when exposed to a bloodborne pathogen incident?

Go to a licensed health care provider for an immediate medical evaluation, counseling, testing and devise a plan for followup care.

What is the OSHA standard for bloodborne pathogens post exposure?

OSHA's Bloodborne Pathogens standard (29 CFR 1910.1030) requires employers to make immediate confidential medical evaluation and follow-up available for workers who have an exposure incident, such as a needlestick.

What must be included in the BBP exposure form?

Detailed Description, including the potentially infectious material (blood, body fluid, etc.), route of exposure (#1-3 listed above), circumstances surrounding the exposure, the sharps device & brand (if applicable), and personal protective equipment being used.

What is the post-exposure protocol for bloodborne pathogens?

Wash the site of the needlestick or cut with soap and water. Flush splashes to the nose, mouth, or skin with water. Irrigate eyes with clean water, saline, or sterile irrigants. Report the incident to your supervisor or the person in your practice responsible for managing exposures.

What is an example of a bloodborne pathogen exposure incident?

Needlesticks or cuts from used needles or sharps. Contact of your eyes, nose, mouth, or broken skin with blood. Assaults – bites, cuts, or knife wounds. Splashes or punctures – especially when drawing blood.

What is the OSHA standard for bloodborne pathogens exposure?

The Bloodborne Pathogen Standard: Requires the use of Universal Precautions, an approach to infection control in which workers treat all human blood and certain human body fluids as if they are known to be infectious, to protect against pathogens.

What is the OSHA protocol for needlestick exposure?

OSHA's Bloodborne Pathogens standard (29 CFR 1910.1030) requires employers to make immediate confidential medical evaluation and follow-up available for workers who have an exposure incident, such as a needlestick.

What does OSHA require to be included on the post-exposure plan?

POST-EXPOSURE EVALUATION AND FOLLOW-UP Obtain consent and make arrangements to have the source individual tested as soon as possible to determine HIV, HCV, and HBV infectivity; document that the source individual's test results were conveyed to the employee's health care provider.

For pdfFiller’s FAQs

What is Bloodborne Pathogen Post-Exposure Incident Form?

The Bloodborne Pathogen Post-Exposure Incident Form is a document used to report and evaluate incidents of potential exposure to bloodborne pathogens, such as HIV, Hepatitis B, and Hepatitis C.

Who is required to file Bloodborne Pathogen Post-Exposure Incident Form?

Employees who experience potential exposure to bloodborne pathogens during their work, particularly in healthcare settings or environments where such exposure may occur, are required to file this form.

How to fill out Bloodborne Pathogen Post-Exposure Incident Form?

To fill out the form, you typically need to provide details about the incident, including the date and time of the exposure, the circumstances surrounding the incident, and any immediate actions taken following the exposure.

What is the purpose of Bloodborne Pathogen Post-Exposure Incident Form?

The purpose of the form is to document exposure incidents to ensure proper evaluation, follow-up care, and to help improve safety measures to prevent future exposures.

What information must be reported on Bloodborne Pathogen Post-Exposure Incident Form?

The form must include information such as the date and time of the incident, the person involved, the source of exposure, any symptoms experienced, and actions taken after the exposure.