Workbook for Designing, Implementing, and Evaluating a Sharps Injury Prevention Program

Contents:

A-6 Sharps Injury Prevention Program Action Plan Forms

These forms are designed to help organizations develop and implement action plans to track and measure their prevention interventions. The first form is specifically designed for prevention initiatives, such as implementation of devices with sharps injury prevention features or changes in work practice. The second form is focused on programmatic changes that will lead to system improvements (e.g., healthcare worker education and training, reporting procedures). Healthcare organizations should use these tools freely and modify them to meet their program needs.

A sample form showing how to complete the first action plan form is included. The numbers on this sample form are fictional and should not be used for comparison purposes.

  Workbook Section Link for this Toolkit Product:
A-6 Worksheet (73 KB/3 pages) / A-6 Worksheet (63 KB/3 pages)

  Organizational Steps
Step 5. Develop and Implement Action Plans