As the health care industry's most comprehensive library of customizable policy and procedure templates, MCN Healthcare's OSHA Compliance Manual includes this customizable template, Accidental Exposure to Blood/Body Fluids - Emergency Department Medical Evaluation Form. MCN's policy library helps you meet compliance with Joint Commission and federal regulations including CMS, CDC, OSHA, OIG, HIPAA and more.

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Here is some sample content from Accidental Exposure to Blood/Body Fluids - Emergency Department Medical Evaluation Form:

	ACCIDENTAL EXPOSURE TO BLOOD/BODY FLUIDS EMERGENCY DEPARTMENT MEDICAL EVALUATION Patient's Medical Record #: EMERGENCY DEPARTMENT NURSE Patient History: Type and Route of Exposure: Exposure Category see policy: Tetanus Status: Hepatitis Vaccine Series Complete?: EMERGENCY DEPARTMENT PHYSICIAN Physician Examination: Management: Source if Known Employee Testing: Follow-up: HIV Test Initial: 6 weeks: 3 months: 6 months: If the staff member's injury meets the HIGH RISK category as set forth by the CDC large bore needle that has been in the patient's vein or artery, he/she is to call the PEP...
Second excerpt:
	...bore needle that has been in the patient's vein or artery, he/she is to call the PEP hotline at 888-448-4911. The PEP hotline physician will recommend the appropriate anti-viral medications as per CDC guidelines for post-exposure prophylaxis. MD Signature: The above are general guidelines and may be altered to accommodate each individual case. Diagnosis: Disposition: 1 Reference #1106...