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SOURCE PATIENT RISK ASSESSMENT Last Name First Name DOB YMD PHN CPI Physician Attach original to Exposure Incident Report Form Give copy to source person completing this form Dear Sir/Madam There are a number of infections such as Hepatitis B Hepatitis C and HIV AIDS which can be spread through blood and other body fluids. Yes No 1. Has the source ever had a tattoo ear or skin piercing acupuncture electrolysis needle stick injury skin graft or come into contact with someone else/s blood If...
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How to fill out source patient risk assessment

01
Start by gathering all necessary information about the patient that is relevant to the risk assessment.
02
Begin by assessing the patient's medical history and any pre-existing conditions that may pose a risk.
03
Evaluate the patient's lifestyle and habits that could contribute to potential risks.
04
Take into consideration any medications the patient is currently taking or has taken in the past.
05
Assess the patient's family history to identify any genetic factors that may increase risk.
06
Conduct a thorough physical examination of the patient to identify any visible signs of risk.
07
Ensure that all necessary forms and documents are properly filled out and signed by the appropriate parties.
08
Keep accurate records of the risk assessment process for future reference and documentation purposes.

Who needs source patient risk assessment?

01
Source patient risk assessment is typically needed for individuals who are undergoing medical procedures or treatments that carry potential risks.
02
It is important for patients who are about to undergo surgery, receive blood transfusions, or undergo any other invasive procedures.
03
Patients with certain underlying medical conditions or a history of certain diseases may also require source patient risk assessment.
04
Healthcare providers may also require source patient risk assessment for individuals who are participating in clinical trials or research studies.
05
Ultimately, the need for source patient risk assessment is determined by the specific medical circumstances and procedures involved.
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Source patient risk assessment is a process used to evaluate the risk of a patient transmitting an infection or disease to healthcare workers or other patients.
Healthcare facilities and providers are required to file source patient risk assessment.
Source patient risk assessments can be filled out by healthcare professionals based on the specific guidelines and forms provided by regulatory bodies.
The purpose of source patient risk assessment is to protect healthcare workers and other patients from potential infections or diseases that could be transmitted by a patient.
Information such as the patient's medical history, potential infectious diseases, and any known risks of transmission should be reported on source patient risk assessment.
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