Get the free Sharps Injury Form Needlestick Report

This form is designed for personnel within organizations to report incidents involving needlestick or sharps injuries. It provides sections for documenting details about the incident, the injured individual, and the circumstances surrounding the injury. The completed form should be submitted to the Public Employment Risk Reduction Program.

How to fill out sharps injury form needlestick

How to fill out sharps injury form needlestick

1. Gather necessary information about the incident including date and time of injury.
2. Identify the type of sharp object that caused the injury.
3. Provide details about the circumstances surrounding the injury, including how it occurred.
4. Record the location where the injury took place.
5. Include personal information of the injured party, such as name and job title.
6. Document any immediate actions taken post-injury, such as first aid administered or medical attention sought.
7. Sign and date the form to verify accuracy of the information provided.
8. Submit the completed form to the appropriate supervisor or safety officer.

Who needs sharps injury form needlestick?

1. Healthcare workers who handle needles and other sharp instruments.
2. Employees involved in medical, laboratory, or maintenance work that includes sharps.
3. Any personnel who may accidentally suffer a needlestick injury.
4. Employers and safety officers needing to document and prevent future incidents.

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What is sharps injury form needlestick?

The sharps injury form needlestick is a document used to report incidents where a healthcare worker is accidentally punctured by a needle or other sharp object, which may expose them to bloodborne pathogens.

Who is required to file sharps injury form needlestick?

Healthcare workers and employees who experience a needlestick or sharps injury are required to file the sharps injury form.

How to fill out sharps injury form needlestick?

To fill out the sharps injury form, the injured employee must provide details about the incident, including the date and time, location, a description of the device involved, and any actions taken following the incident.

What is the purpose of sharps injury form needlestick?

The purpose of the sharps injury form is to document the incident, facilitate reporting and investigation, and improve workplace safety by identifying areas for risk reduction.

What information must be reported on sharps injury form needlestick?

Information that must be reported includes the date and time of the injury, details of the sharp device, the involved employee's information, the circumstances surrounding the injury, and the follow-up actions taken.