Uniform Blood and Body Fluid Exposure Report
77 Hospitals, 1993-1995Total Cases: 7
| JOB CATEGORY |
| M.D. (attending/staff) |
2 |
29% |
| M.D. (intern/resident/fellow) |
0 |
0% |
| Medical student |
0 |
0% |
| Nurse RN/LPN |
0 |
0% |
| Nursing student |
0 |
0% |
| Respiratory therapist |
0 |
0% |
| Surgery attendant |
0 |
0% |
| Other attendant |
0 |
0% |
| Phlebotomist/venipuncture/I.V. team |
0 |
0% |
| Clinical laboratory worker |
2 |
29% |
| Technologist (non-lab) |
1 |
14% |
| Dentist |
0 |
0% |
| Dental hygienist |
0 |
0% |
| Housekeeper/laundry worker |
0 |
0% |
| Other |
2 |
29% |
| ( 0 missing) |
| PLACE OF OCCURRENCE |
| Where did the injury occur in the institution? |
| Patient room |
0 |
0% |
| Outside patient room |
0 |
100% |
| Emergency department |
0 |
0% |
| Intensive/critical care unit |
0 |
0% |
| Operating room |
0 |
0% |
| Outpatient clinic/office |
0 |
0% |
| Blood bank |
0 |
0% |
| Venipuncture |
0 |
0% |
| Dialysis facility |
0 |
0% |
| Procedure room |
0 |
0% |
| Clinical laboratories |
0 |
0% |
| Autopsy/pathology |
7 |
100% |
| Service/utility area |
0 |
0% |
| Other |
0 |
0% |
| ( 0 missing) |
| SOURCE PATIENT |
| Was the source patient known? |
| Yes |
6 |
86% |
| No |
0 |
0% |
| Unknown |
0 |
0% |
| N/A |
1 |
14% |
| ( 0 missing) |
| BODY FLUIDS |
| Which body fluids were involved in the exposure? |
| Blood or blood product |
5 |
71% |
| Vomit |
0 |
0% |
| CSF |
1 |
14% |
| Peritoneal fluid |
0 |
0% |
| Pleural fluid |
1 |
14% |
| Amniotic fluid |
0 |
0% |
| Urine |
1 |
14% |
| Other |
1 |
14% |
| EXPOSED PART |
| Was the exposed part: |
| Intact skin |
4 |
57% |
| Non-intact skin |
0 |
0% |
| Eye(s) |
3 |
43% |
| Nose |
1 |
14% |
| Mouth |
0 |
0% |
| Other |
0 |
0% |
| TYPE OF EXPOSURE |
| Did the blood or body fluid: |
| Touch unprotected skin |
6 |
86% |
| Touch skin through gap between protective garments |
0 |
0% |
| Soak through protective garment |
0 |
0% |
| Soak through clothing |
1 |
14% |
| PROTECTIVE ITEMS WORN |
| Which protective items were worn at the time of the exposure? |
| Single pair latex/vinyl gloves |
5 |
71% |
| Double pair latex/vinyl gloves |
1 |
14% |
| Goggles |
0 |
0% |
| Eyeglasses |
1 |
14% |
| Faceshield |
0 |
0% |
| Surgical mask |
0 |
0% |
| Surgical gown |
1 |
14% |
| Plastic apron |
0 |
0% |
| Lab coat, cloth |
0 |
0% |
| Lab coat, other |
0 |
0% |
| Other item |
0 |
0% |
| RESULT |
| Was the exposure the result of: |
| Direct patient exposure |
4 |
57% |
| Specimen container leaked/spilled |
0 |
0% |
| Specimen container broke |
1 |
14% |
| IV tubing/bag/pump leaked |
0 |
0% |
| Other body fluid container spilled/leaked |
0 |
0% |
| Touched contaminated equipment |
0 |
0% |
| Touched contaimnated drapes/sheets, etc. |
0 |
0% |
| Unknown |
0 |
0% |
| Other |
1 |
14% |
| ( 0 missing) |
| TIME IN CONTACT |
| For how long was the blood or body fluid in contact with your skin or mucous membranes? |
| Less than 5 minutes |
5 |
71% |
| 5-14 minutes |
1 |
14% |
| 15 minutes - 1 hour |
0 |
0% |
| More than 1 hour |
1 |
14% |
| ( 0 missing) |
| QUANTITY |
| Estimate the quantity of blood/body fluid that came in contact with your skin or mucous membranes: |
| Small amount (up to 5 cc) |
5 |
71% |
| Moderate amount (5-50 cc) |
1 |
14% |
| Large amount (more than 50 cc) |
1 |
14% |
| BODY PART |
| Right hand, back |
0 |
| Right hand, front |
1 |
| Left hand, front |
0 |
| Left hand, back |
0 |
| Right arm |
0 |
| Left arm |
0 |
| Head |
6 |
| Chest |
0 |
| Back |
0 |
| Mid-body |
1 |
| Right leg |
0 |
| Left leg |
1 |
| Right foot |
0 |
| Left foot |
0 |
| OSHA |
| Is this incident OSHA reportable? |
| Yes |
0 |
0% |
| No |
7 |
100% |
| ( 0 missing) |
| For those cases that are OSHA reportable: |
| Cumulative number of days away from work: |
0 |
| Cumulative number of days of restricted work activity: |
0 |
|
