Get Michigan State University Sharps Injury Log 2010

Filling out the Michigan State University Sharps Injury Log is an important step in documenting exposure incidents involving sharps. This guide will provide you with clear, step-by-step instructions to ensure you complete the form accurately and effectively.

Follow the steps to fill out the Michigan State University Sharps Injury Log online.

1. Press the ‘Get Form’ button to access the form and open it for completion.
2. Enter the social security number of the individual affected by the sharps injury.
3. Fill in the name of the claimant as well as their telephone number.
4. Provide the name of the supervisor overseeing the affected employee.
5. Input the date of birth of the claimant.
6. Indicate the gender of the claimant by marking the corresponding circle.
7. Specify the department where the incident occurred.
8. Detail the building and area of injury.
9. Record the date the injury took place.
10. Note the time of injury and specify whether it was a.m. or p.m.
11. Describe the exposure incident in the designated section.
12. Select the job classification of the claimant by marking the appropriate circle.
13. Indicate the procedure associated with the injury by filling in the relevant circle.
14. Select the body part affected by checking all applicable options.
15. Identify the department or location where the incident occurred.
16. Report how the exposure incident occurred by selecting the correct options.
17. Identify the sharp instrument involved in the incident, including type, brand, and model if known.
18. Specify if the device had engineered sharps injury protection, marking yes, no, or don’t know.
19. Indicate whether the protective mechanism was activated and when the exposure occurred.
20. If applicable, provide opinions regarding whether engineered sharp injury protection could have prevented the injury and explain any additional controls that could help.
21. Once all information is completed, save any changes made, then proceed to download or print the form as necessary.

Complete the Michigan State University Sharps Injury Log online today to ensure accurate reporting and compliance.