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BLOOD-BORNE PATHOGENS POSTEXPOSURE REPORT
Confidential
System wide Safety Programs Unit
MONTGOMERY COUNTY PUBLIC SCHOOLS
Rockville, Maryland 20850MCPS Form 23033
July 2012INSTRUCTIONS: This form is
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How to fill out bloodborne pathogens post-exposure report

How to fill out bloodborne pathogens post-exposure report
01
Gathering information: Write down the date, time, and location of the exposure incident.
02
Identify the source: Record the name and contact information of the person or patient who may have exposed you to bloodborne pathogens.
03
Describe the exposure: Document the circumstances of the exposure, including how it occurred and what body fluids were involved.
04
Seek medical evaluation: Note the healthcare professional or facility where you received a post-exposure evaluation and any relevant findings.
05
Report follow-up: Keep track of any further medical treatment or testing that you may have undergone.
06
Submit the report: Send the completed bloodborne pathogens post-exposure report to the appropriate authority or department within your organization.
Who needs bloodborne pathogens post-exposure report?
01
Healthcare workers who have been exposed to blood or other potentially infectious materials.
02
First responders, such as paramedics or emergency medical technicians, who come into contact with bodily fluids while performing their duties.
03
Laboratory personnel who handle specimens that may contain bloodborne pathogens.
04
Workers in industries where there is a risk of exposure to blood or body fluids, such as janitorial staff or tattoo artists.
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What is bloodborne pathogens post-exposure report?
A bloodborne pathogens post-exposure report is a document used to record details and incidents of exposure to bloodborne pathogens, such as HIV, hepatitis B, and hepatitis C, in order to evaluate and manage the risks associated with the exposure.
Who is required to file bloodborne pathogens post-exposure report?
Any employee who has been exposed to bloodborne pathogens in the workplace, along with their employers and healthcare providers, are required to file a bloodborne pathogens post-exposure report.
How to fill out bloodborne pathogens post-exposure report?
To fill out a bloodborne pathogens post-exposure report, an individual must provide the date and time of the exposure, a description of the incident, the type of exposure, and any immediate actions taken, as well as information about the exposed individual and the source of the exposure.
What is the purpose of bloodborne pathogens post-exposure report?
The purpose of a bloodborne pathogens post-exposure report is to document the incident, initiate follow-up procedures, ensure that proper medical evaluations are conducted, and improve workplace safety by analyzing and preventing future exposures.
What information must be reported on bloodborne pathogens post-exposure report?
The report must include details such as employee's name, date of exposure, nature of exposure, type of fluid involved, circumstances of the exposure, immediate actions taken, and any medical evaluations or follow-up treatment received.
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