Get the free Post-Exposure Evaluation and Follow-Up Form - ehis fullerton

This form is used by employees of California State University, Fullerton, to report potential exposure to blood or infectious materials and to document their acceptance or declination of vaccines

How to fill out post-exposure evaluation and follow-up

How to fill out Post-Exposure Evaluation and Follow-Up Form

1. Obtain the Post-Exposure Evaluation and Follow-Up Form from your healthcare provider or the appropriate department.
2. Fill out personal information, including your name, contact information, and job title.
3. Provide details about the exposure incident, including date, time, and location.
4. Describe the nature of the exposure, including what you were exposed to and how it occurred.
5. List any symptoms you are experiencing following the exposure.
6. Include any relevant medical history that may affect your evaluation.
7. Submit the completed form to your healthcare provider for further review and follow-up.

Who needs Post-Exposure Evaluation and Follow-Up Form?

1. Employees or individuals who have had potential exposure to infectious agents or hazardous materials in the workplace.
2. Healthcare workers who may have been exposed to bloodborne pathogens or other biological hazards.
3. Anyone who experiences an exposure incident that requires medical evaluation and follow-up.

People Also Ask about

What time post-exposure is to be followed if a worker is exposed to HBV?

Currently, for employees who have not received the HBV vaccine series, HBV vaccine (and in some circumstances hepatitis B immune globulin) is to be offered as soon as possible after the exposure incident, but no more than seven days after the incident.

What should a post-exposure evaluation include?

The post-exposure follow-up must include counseling the worker about the possible implications of the exposure and his or her infection status, including the results and interpretation of all tests and how to protect personal contacts.

What are the requirements for the medical evaluation and follow up after an exposure incident?

An employer needs to make the following available at no cost to the affected employee after an exposure: Confidential medical evaluation at a pre-established location. Blood testing. Confidential follow-up appointments. Source patient testing results. Counseling. Evaluation of reported illnesses. Documentation.

How long after exposure to hepatitis B are you contagious?

You're contagious as long as the virus is active in your body. For example, acute hepatitis B can last for up to six months. You can spread the virus that entire time. If you have active chronic hepatitis B, you'll be contagious for the rest of your life.

How soon after a potential exposure should the exposed person be tested for HBV?

Testing immediately after exposure should consist of total anti-HBc, and follow-up testing approximately 6 months later should consist of HBsAg and total anti-HBc.

How long after exposure to hepatitis B should I get tested?

More Detailed Information About Hepatitis B Blood Tests HBsAg (hepatitis B surface antigen) is the first serologic marker to appear in a new acute infection, which can be detected as early as 1 week and as late as 9 weeks (range: 6-60 days), with an average of one month after exposure to the hepatitis B virus (HBV)[1].

What timely post-exposure is to be followed if a worker is exposed to HBV?

Currently, for employees who have not received the HBV vaccine series, HBV vaccine (and in some circumstances hepatitis B immune globulin) is to be offered as soon as possible after the exposure incident, but no more than seven days after the incident.

Where would you go to follow up for post-exposure testing should an exposure occur?

Infectious disease physician or group. This is their area of expertise, and they are well versed in the current CDC guidelines, the diseases and counseling issues. Infectious disease physicians can be contacted by the DICO regarding exposure events at any time (24/7).

For pdfFiller’s FAQs

What is Post-Exposure Evaluation and Follow-Up Form?

The Post-Exposure Evaluation and Follow-Up Form is a documented procedure used to assess and manage individuals who have potentially been exposed to infectious materials, ensuring they receive appropriate medical evaluation and follow-up.

Who is required to file Post-Exposure Evaluation and Follow-Up Form?

Individuals who have experienced a potential exposure to infectious materials, such as healthcare workers, must file the Post-Exposure Evaluation and Follow-Up Form as part of their health and safety protocols.

How to fill out Post-Exposure Evaluation and Follow-Up Form?

To fill out the Post-Exposure Evaluation and Follow-Up Form, provide relevant personal information, details of the exposure incident, the circumstances surrounding it, and any immediate medical attention received. Follow institutional guidelines for completing the form.

What is the purpose of Post-Exposure Evaluation and Follow-Up Form?

The purpose of the Post-Exposure Evaluation and Follow-Up Form is to document the exposure event, facilitate appropriate medical care, monitor the health outcomes of the individual involved, and ensure compliance with regulatory and institutional requirements.

What information must be reported on Post-Exposure Evaluation and Follow-Up Form?

The form typically requires information such as the date and time of exposure, the nature of the exposure, details of the source patient or material, the recipient's medical history, and any actions taken following the exposure.