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Do�.jrs Hospital D artmen,t In-Service Si n In Swkeet ADMIN <br /> OfMantcca All lTds must be filled in - PLEAS RINT <br /> CLASS TITLE <br /> Hazardous WasteManement _ <br /> DATE May 1 st _ 11fith. <br /> CIRCLE ONE Mandatory Non-mandatory <br /> START TIME <br /> TOTAL HOURS <br /> C.E.U. APPROVED HOURS <br /> LOCATION Unit Rounding <br /> INSTRUCTORS Department Directors, Clinical Managers, Shift Managers <br /> TARGET AUDIENCE All clinical staff <br /> TEACHING METHODS: Lecture Self study Discussion Demonstration Video <br /> Circle all that apply Resource Binder <br /> DEPARTMENTS ICU, MS, MSS, Perinatal, OR, D <br /> LEARNING OBJECTIVES 1• Proper identification of hazardous was <br /> 2. Proper identification of waste disposal containers <br /> (clearly state) 3 Verbalize understanding of laws and regulations pertaining to waste disposal <br /> 4. Discussion of improper changing of containers and cost related to inappropriate use <br /> REASON: Circle all that Individual staff needs Patient population/Age specific <br /> apply Equipment Technolo New/Revised Policy Procedure <br /> PARTICIPANT Post test Return demo Competency Re-monitor <br /> EVALUATION METHOD QI Change in clinical practice OTHER <br /> RINT NAME (First & Last) DEPT EMP NontErnp ADMIN <br /> 1 <br /> 3 �' ► 1 <br /> —L_Q <br /> 5 <br /> 6 <br /> �s-��o-r/ i-moi �Syzcdy✓S' �,---7`7i <br /> ti <br /> 9 <br /> 10 <br /> 11 <br /> 12 ww �l � <br /> 13r � <br /> &_T_ L <br /> G �.J <br /> HAIn Service Sign-In sheets.doc ' <br />