7.15

EXPOSURE CONTROL PLAN

INFORMATION PROVIDED TO THE HEALTHCARE PROFESSIONAL

The healthcare professional evaluating an employee after an exposure incident shall be provided with a copy of the OSHA Occupational Exposure to Bloodborne Pathogens standard as well as the information on this form.

Date________________________________________________

Name of Exposed Employee_____________________________

Department___________________________________________

1. Describe the exposed individual's duties as they relate to the exposure incident.

 

2. Describe the route(s) of exposure and circumstances under which exposure occurred.

 

3. Provide the results of the source individual's blood testing, if available.

 

4. Provide all medical records relevant to the appropriate treatment of the employee, including vaccination status. These are the department head's responsibility to maintain (attach copies).