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Student Accident and Needle Stick Form - Texas A&M College

Student Accident and Needle Stick Form - Texas A&M College 2025

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4.8 out of 5

203 votes

The document is a Student Injury/Exposure Incident Report Form for Texas A&M Health Science Center, designed to be completed within 48 hours of any incident involving student injuries or exposure to infectious diseases during coursework. It includes sections for personal information, incident details, injury descriptions, and witness information. The form emphasizes the importance of privacy and compliance with state laws regarding health information. Additionally, it provides instructions for reporting contaminated sharps injuries and outlines the necessary steps for documentation and submission.

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Click ‘Get Form’ to open it in the editor.
Begin by entering your personal information in the 'STUDENT' section, including your name, email address, phone number, and UIN. Ensure all details are accurate for effective communication.
In the 'TIME & PLACE' section, specify the date and time of the incident along with a detailed location description. Be as specific as possible to aid in incident tracking.
Describe what happened in the 'INCIDENT DESCRIPTION' field. Include details about the injury type, severity, and affected body parts in the 'DESCRIPTION OF INJURY' section.
Indicate whether first aid was given and if you were transported for care. Mark any affected areas on the body diagram provided.
Complete the 'DETAIL OF INCIDENT' section by checking applicable boxes related to the nature of the incident and providing witness information if available.
Finally, ensure that all required fields are filled out before submitting your form via email to HSC-IncidentReporting@tamhsc.edu.

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Versions	Form popularity	Fillable & printable
2019	4.8 Satisfied (203 Votes)

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How to write an incident report for needle stick injury?

Take detailed information about the injury, including how long ago it happened, how deeply the skin was penetrated, whether or not the needle was visibly contaminated with blood, and any first aid measures used. Explain the transmission risks, which are small.

What steps are to be taken with an accident needle stick?

What protocol should be followed after any needlestick? The site should be immediately washed with soap and water. The incident should be reported and an exposure report sheet completed. The exposure should be assessed (type of fluid, type of needle, amount of blood on the needle, etc).