Follow the steps to complete the Blood And Body Fluid Exposure Report online.

1. Press the ‘Get Form’ button to access the form and open it in your preferred online editor.
2. Enter your last name in the designated field.
3. Input your first name in the corresponding field.
4. Provide the Exposure ID where prompted.
5. Input the Facility ID for office use only, as specified.
6. Fill in the date of exposure in the appropriate section.
7. Enter the time of exposure.
8. Identify the department where the incident occurred by writing in the appropriate field.
9. Indicate your home department in the specified section.
10. Select only one option regarding where the exposure occurred (e.g., Patient Room, Operating Room, etc.) by marking the box next to your choice.
11. Check whether the source patient was identifiable by selecting one of the options (Yes, No, Unknown).
12. Choose your job category from the list provided, marking only one box for the option that best describes your role.
13. Indicate which body fluids were involved in the exposure by checking all applicable boxes.
14. Specify whether the body fluid was visibly contaminated with blood.
15. Define the exposed part by checking all applicable boxes.
16. Select how the blood or body fluid interacted with your skin or mucous membranes by marking the relevant boxes.
17. Check the barrier garments that were worn at the time of exposure.
18. Identify the cause of the exposure by selecting one option from the list.
19. If any equipment failure occurred, specify the equipment type and manufacturer.
20. Indicate how long the blood or body fluid was in contact with your skin or mucous membranes.
21. Estimate the amount of blood/body fluid that came in contact with your skin or mucous membranes.
22. Fill in the location details by assigning numbers to the exposed body parts.
23. Describe the circumstances leading to the exposure in the space provided.
24. State whether you believe that any other controls could have prevented the injury, and provide a description if applicable.
25. Input any costs associated with the incident in the designated sections for various charges.
26. Answer whether this incident is OSHA reportable and provide details if applicable.
27. Determine if the incident meets FDA medical device reporting criteria.
28. Once all sections are completed, review the form for accuracy. You can then save, download, print, or share the form as needed.

Complete your Blood And Body Fluid Exposure Report EPINet - Uthsc online today.