Get Needlestick Amp Sharp Object Injury Report Epinet - Uthsc

This guide provides comprehensive instructions for filling out the Needlestick Amp Sharp Object Injury Report EPINet - Uthsc online. It is designed to assist users in accurately reporting injuries related to needlesticks and sharp objects in a clear and supportive manner.

Follow the steps to successfully complete the form.

1. Press the ‘Get Form’ button to obtain the injury report form and open it in your preferred online editor.
2. Begin by entering the last name of the injured person in the designated field.
3. Provide the first name of the injured individual in the corresponding field.
4. If applicable, fill in the injury ID in the office-use section.
5. Select the appropriate facility ID in the designated area for office use.
6. Indicate who completed the report by filling in your name in the 'Completed By' section.
7. Record the date when the injury occurred in the provided field.
8. Specify the department where the incident took place in the respective section.
9. Enter the home department of the injured person in the relevant space.
10. Document the exact time the injury occurred in the respective field.
11. Choose the job category of the injured worker by checking the appropriate box and specifying any requested specialty.
12. Indicate the location where the injury occurred by selecting from the provided options.
13. State whether the source patient was identifiable by checking the suitable box.
14. Confirm if the injured worker was the original user of the sharp item by checking the applicable box.
15. Specify whether the sharp item was contaminated, uncontaminated, or unknown by selecting the appropriate checkbox.
16. Identify the sharp item involved in the injury by checking the relevant description.
17. Select what type of device caused the injury by checking the corresponding box.
18. If applicable, indicate the brand and model of the product involved in the incident.
19. State whether the sharp medical device had a safety design by checking the relevant option.
20. If needed, describe the circumstances surrounding the injury in the provided text box.
21. Complete any additional questions regarding engineering controls or work practices that might have prevented the injury.
22. Fill out the cost-related fields as applicable.
23. Finally, review all entries for accuracy, then save changes, download, print, or share the completed form as needed.

Complete your Needlestick Amp Sharp Object Injury Report online today!