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Doctors Hospital De tmen In-Service Sign In S t <br /> All fields must. be filled in — PLEASE PRINT <br /> CLASS TITLE <br /> IHazardous Waste Management <br /> .SATE May 1 sl 1 pth <br /> .;IRCLE ONE Mandator Non-mandatory <br /> START TIME <br /> TOTAL HOURS <br /> C.E.U. APPROVED HOURS <br /> LOCATION Unit Rounin <br /> INSTRUCTORS Departme t Directors, Clinical Managers, Shift Managers <br /> TARGET AUDIENCE All clinicalistaff <br /> TEACHING METHODS: Lecture Self study Discussion Demonstration Video <br /> Circle all that appLy Resourc Binder <br /> DEPARTMENTS ICU, MS, SS, Perinatal, R, D <br /> LEARNING OBJECTIVES 1. Proper enliflcationofhazard e <br /> 2. Proper entiricalion of waste disposal containers <br /> (clearly state) 3. Verbali 11 <br /> understanding of laws and regulal ons pertaining to waste disposal <br /> 4. Discus ion of improper changing of containers and cost related to inappropriate use <br /> REASON: Circle all that Individua staff needs Patient population/Age specific <br /> apply Equipment TechnoloNew/Revised Policy Procedure <br /> PARTICIPANT Post test ; Return demo Competency Re-monitor <br /> EVALUATION METHOD QI C an a in clinical practice OTHER <br /> -- PRINT NAME Yr�t & Last DEPT >�mlr Nont >Erne ADMlN <br /> 2 V <br /> A� <br /> G <br /> r <br /> s Cy Oft, <br /> 6e, <br /> 13 <br /> i <br /> HAIn Service Sign-In shocts.doc t <br />