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Oakland University Bloodborne Pathogen Exposure Incident Report Form free printable template

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EXPOSURE INCIDENT REPORT FORM Date of Incident Job site/location: Time of Incident Name of Employee Job Description (Description of General Duties): Potentially Infectious Material Involved (e.g.
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How to fill out Oakland University Bloodborne Pathogen Exposure Incident Report

01
Begin by downloading the Oakland University Bloodborne Pathogen Exposure Incident Report form from the university's health and safety website.
02
Fill out the basic information section, including your name, contact information, and date of the incident.
03
Provide details of the exposure incident, including the date, time, and location of the incident.
04
Describe the nature of the exposure (e.g., needlestick, cut, splash) and the body fluids involved.
05
Include information on the source individual (if known), such as their name and medical history if relevant.
06
Record any immediate actions taken after the exposure, such as cleaning the wound or seeking medical attention.
07
Sign and date the report, and indicate whether you want to remain anonymous.
08
Submit the completed form to the designated university representative, as outlined in the reporting instructions.

Who needs Oakland University Bloodborne Pathogen Exposure Incident Report?

01
University employees who have experienced a potential exposure to bloodborne pathogens.
02
Students in health-related fields who may come into contact with blood or bodily fluids during clinical training.
03
Any staff member involved in an incident that could pose a risk of exposure to infectious materials.
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It is a report used to document incidents of exposure to bloodborne pathogens in accordance with safety regulations at Oakland University.
Any employee, student, or individual who experiences an exposure incident involving bloodborne pathogens is required to file the report.
The report should be filled out by providing detailed information about the incident, including the date, time, location, description of the exposure, and any medical treatment received.
The purpose is to ensure proper documentation of exposure incidents for follow-up procedures, compliance with safety protocols, and to initiate necessary medical evaluation.
The report must include the names of the individuals involved, a description of the exposure incident, the date and time of the incident, location, and any actions taken following the exposure.
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