name of the health facility
Age
Sex
Religion
Ethnicity
educational status
Marital status
current avarage monthly income
service year
currently assigned ward
profession/occupational catagory
knowladege about universal precaution guidline
participated in training of IP/UP
Ever collected blood sample
cleaning hand after collection/touching blood
methods used to clean hand
wear personal protective equipments
why you haven't used PPE
use of gloves as PPE
exposure yo blood ungloved
frequency of exposure ungloved
History of exposure to body fluids
frequency of exposure to body fluids
Washing with alcohol/soap
Applying pressure to stop bleeding
Dressing the wound
squizing to extract more blood
Inform/report to the supervisor or senior
others specify
should needle recapped/bent after use
ever practiced needle reccaping
ever experianced needle stick injury
frequency of needle stick injury
patient non compliant
during needle reccaping
by otherstaff members
others
have you reported the incedent of NSI
unawere of reporting procedure
nt thought it was not important
thought nothing was done
the source patient was low risk
history of sharp injury
frequency of sharp injury
g squizing the site of injury
cleaned the area with alcohol
having tested for blood borne pathogen
nothing was done
wash with alcohol/soap
inform/report to the supervisor
other specify
History of operation/surgery
History of blood transfusion
History of jaundice or diagnosed liver diseased
history of tattoing
history of tooth extraction
experiancing multiple sexual partner in the last 1 year
experiancing multiple sexual partner in the last 3 months
Having ever traded sex
ever had sex with commercial sex worker
family history of Chronic liver disease
ever vaccinated for HBV
HBsAG test result
Newly labeled exposure to blood ungloved
Newly categorized exposure to boody fluids
Newly categorized should needle be recapped
Newly labeled history of sharp injury
Newly labeled history of surgery
Newly cateogried history of blood transfusion
Newly categorized history of tattoing
Newly categorized history of multiple sexual partner
Nely categorized avarage monthly income