All data is confidential and no facility will be named without their permission.

* 1. Is your facility a hospital (AHA “≥6 overnight beds”)

* 2. If not a hospital, what is the nature of your non-hospital setting? (e.g. Dialysis Clinic, Home Health, School, Mining, etc)

* 3. Total number of sharps injuries reported from all sources (i.e. OSHA Log + all others including employees and non-employees)

* 4. Total Number of mucocutaneous blood or potentially infectious material exposures (including bites) from employees and non-employees in 2016.

* 5. Number of sharps injuries in surgical procedures (i.e. OR + Procedure Rooms + Labor & Delivery) in 2016.

* 6. Number of sharps injuries reported by nurses in 2016 (e.g. RN, LPN/LVN)

* 7. Number sharps injuries reported by doctors in 2016.

* 8. (Hospitals only) Number of hospitals included in the above exposure data (separate data for each is preferred)
(If you wish to use Excel to insert each facility's data please contact Terry Grimmond on terry@terrygrimmond.com for form)

* 9. (Hospitals only) Average Daily Inpatient Census (i.e. average nightly Occupied Beds) for 2016. Note: This is always less than “Staffed beds” and is NOT “Adjusted Daily Census”.

* 10. Average number of Full Time Equivalents (FTE) for all staff. Total FTE = Total Hours worked by all staff from OSHA 300A, divided by 2000.

* 11. Average number of NURSING Full Time Equivalent (FTE) staff in 2016 (i.e. RN, LPN/LVN). Total Nursing FTE = Total Hours worked by all Nursing staff/2000.

* 13. In what state is your facility located?

* 14. May we contact you if we need clarify an answer with you? If so, may we have:

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