CLEVELAND CLINIC FOUNDATION OSHA REQUIRED BLOODBORNE PATHOGEN TRAINING

Documentation of Training

Your Name (PRINT)

Your job title

Check one: New Hire Newly Assigned Annual Retraining OSHA Trainer Training Date(s) Comet computer based training supplemented with unit specific training completed on ______________ Unit Trainer(s) signature________________________ Trainer(s) printed name, title, department ______________________________________ Your Department

TRAINING CONTENT Bloodborne Pathogen Standard -Provided via Comet • Bloodborne pathogens

• Type • Transmission via occupational exposure

• Engineering controls • Work practice controls • Personal protective equipment (PPE)

• Contamination of PPE • Cleaning work surfaces • Exposure control plans

• Master exposure control plan • Unit specific exposure control plans

• Exposures • Definition of exposure • What to do if exposed • Exposure hotline • Post-exposure blood testing & treatment

• Hepatitis B vaccine • Labels • Post training test Department and job specific training –Provided by unit trainer • Location and use of PPE • Location of unit specific exposure control plan • Type and use of engineered sharp safety devices • Any unit specific work practice controls

I completed annual bloodborne pathogen training on the date(s) indicated above. I understand that I am subject to disciplinary action (major infraction) if I willfully violate the OSHA Bloodborne Standard. SIGNATURE: _______________________________ DATE: ________________ Employees: Return signed form to your supervisor Physicians: Send original signed form to your primary department.

THIS TRAINING IS REQUIRED ANNUALLY

Supervisor: You must ensure affected workers receive departmental and job specific training. Training solely by means of a video or computer program does not meet the training requirements of the Bloodborne Pathogen Standard of the Occupational Safety and Health Administration. A qualified trainer must be accessible for interaction. Trainers must be knowledgeable in the subject matter covered by the elements in the training program and be familiar with how the course topics apply to the workplace that the training will address. The trainer must demonstrate expertise in the area of occupational hazards of bloodborne pathogens. Documentation of training must be maintained for three (3) years from date of training in a readily accessible departmental file or the worker’s personnel file.

I:\COMET\COMET_WEB\JCAHO_OSHA\Bloodborne Pathogens\BP_training_record.doc