Get the free Sharps Injury Form Needlestick Report - OhioBWC

Public Employment Risk Reduction Program State of Ohio Division of Safety and Hygiene 13430 Yarmouth Drive Pickering ton, Ohio 43147 614-644-2246 or 800-671-6858 Fax: 614-644-3133 Sharps Injury Form

How to fill out sharps injury form needlestick

How to fill out sharps injury form needlestick:

1. Obtain the sharps injury form needlestick from your workplace's human resources or occupational health department.
2. Fill out your personal information, such as your name, employee ID, and contact details.
3. Provide details about the incident, including the date, time, and location of the needlestick injury.
4. Describe the type of sharp object involved, such as a needle or scalpel.
5. Provide information about the patient or source of the injury, such as their name, identification number, and medical history (if known).
6. Explain the circumstances surrounding the injury, including the activity you were engaged in at the time.
7. Indicate if you were wearing any personal protective equipment (PPE) and whether the injury occurred despite its use.
8. Include details about your immediate actions following the injury, such as cleaning the wound or seeking medical attention.
9. Sign and date the form to certify that all the information provided is accurate.
10. Submit the completed sharps injury form to the designated department within your workplace for further evaluation and processing.

Who needs sharps injury form needlestick:

1. Healthcare professionals such as doctors, nurses, laboratory technicians, and other medical staff who may come into contact with sharps during their work.
2. Any employee working in an environment where there is a risk of exposure to infectious materials, such as janitors or waste management staff.
3. Individuals who experience a needlestick or sharps injury in a non-medical setting, such as those working with syringes or needles in salons, tattoo parlors, or research laboratories.

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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 injured by a needle or other sharp object.

Who is required to file sharps injury form needlestick?

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

How to fill out sharps injury form needlestick?

The sharps injury form should be filled out with details of the incident, including date, time, location, the type of sharp object involved, and a description of the injury. Additional information, such as the circumstances leading to the incident and any contributing factors, should also be included.

What is the purpose of sharps injury form needlestick?

The purpose of the sharps injury form needlestick is to collect data on sharps injuries and needlesticks in healthcare settings. This data can be used to identify trends, implement preventative measures, and improve the safety of healthcare workers.

What information must be reported on sharps injury form needlestick?

The sharps injury form should include information such as the healthcare worker's name, job title, department, and contact information. It should also include details of the incident, including the type of sharp object, the location where the incident occurred, and any contributing factors.