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

Contents:

A-8 Sharps Injury Hazard Observation and Report Forms

Healthcare organizations that collect information on sharps injury hazards in the work environment may find the following forms useful. The first form (A-8-1) is for organizations that perform systematic environmental rounds and provides a means for documenting specific sharps injury hazards observed in the course of conducting rounds. The second form (A-8-2) is for use by individual workers who observe a sharps injury hazard in the work environment or is reporting a “near miss” event. The form provides a means for documenting the observation and communicating the problem to administrative personnel. Healthcare organizations may download these resources and adapt them as necessary to meet their organization's needs.

  Workbook Section Link for this Toolkit Product:
A-8 Worksheet (81 KB/2 pages) / A-8 Worksheet (64 KB/2 pages)

  Operational Processes
Implement Procedures for Reporting Sharps Injuries and Injury Hazards