Data must come from the same institution/s from which your OSHA 300 Log data is derived.
All answers must pertain to the same hospital/facility.
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, etc)

* 3. Number of sharps injuries from your 2016 calendar year OSHA Form 300.

* 5. If Q4 answer is “No”, how many sharps injuries additional to OSHA 300 Log were reported in 2016?

* 6. Number of mucocutaneous blood or potentially infectious material exposures (including bites) in 2016.

* 7. Please confirm TOTAL Sharps injuries reported to you in 2016 by employees and non-employees (should equal Question 4 + Question 5)

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

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

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

* 11. How many sharps injuries were reported to you by non-employee medical staff in 2016?

* 12. How many sharps injuries were reported by employed medical staff in 2016?

* 13. (Hospitals only) Average number of staffed beds in the hospital/s from which exposure data came?

* 14. (Hospitals only) Number of hospitals included in the above exposure data (separate data for each is preferred)
(Please enter data for 1 facility per survey. If you cannot separate each facility's data please contact Terry Grimmond on for method)

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

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

* 17. 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.

* 18. Adjusted Patient Days for 2016 (available from your Finance Dept)

          Adjusted Patient Days = (Total Revenue / Inpatient Revenue) x Total Inpatient Days

* 20. In what state is your facility located?