Get Contaminated Sharps Injury Reporting Form - Wtamu

Filling out the Contaminated Sharps Injury Reporting Form is essential for documenting exposure incidents involving sharp objects. This guide provides a step-by-step approach to completing the form online, ensuring that all necessary information is accurately captured.

Follow the steps to fill out the form accurately.

1. Press the ‘Get Form’ button to access the form and open it in your online editor.
2. Begin by entering the facility where the injury occurred. Provide the complete street address, excluding P.O. Boxes, along with the city, county, and zip code.
3. Fill in the date that you are completing the form along with your name, phone number, and email address.
4. Indicate the date and time of the injury. Include the age and sex of the injured person in the required fields.
5. Select the type of sharp involved in the incident from the drop-down list. Options may include needles, surgical instruments, or glass items. Enter the brand name of the sharp in the designated field.
6. Detail the original intended use of the sharp and indicate when and how the injury occurred by selecting appropriate options.
7. Answer whether the device had engineered sharps injury protection, and if applicable, indicate whether the protective mechanism was activated.
8. Specify whether the injured person was wearing gloves during the incident and if they had completed a hepatitis B vaccination series.
9. Indicate if a sharps container was available for disposal and if it provided a clear view of the level of contaminated sharps.
10. Document any relevant comments, notes, or suggestions in the comments section.
11. Confirm the location where the injury occurred, the work area, and the injured person's job classification and employment status.
12. Once all fields are accurately filled out, save your changes. Download, print, or share the completed form as necessary.

Complete your documents online today to ensure timely reporting of sharps injury incidents.