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Doctors Hospital D rtment In-Service Sign In SJ&eet nUM/N <br /> of Malacca All fi ds must be 'filled in — PLEASEWRINT <br /> r.,,ecoida, o <br /> CLASS TITLE <br /> Hazardous Waste Management <br /> DATE May 1 St — 101h p 19 <br /> _ <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, ED h&rM <br /> LEARNING OBJECTIVES 1. Proper identification of hazardous waste <br /> 2. Proper identification of waste disposal conta ers <br /> (clearly state) 3. Verbalize understanding of laws and regulatio erl to waste disposal <br /> 4 Discussion of improper changing of containers an 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 /> PRINT NAME First & Last) DEPT EMP NontEmp ADMIN <br /> 1 <br /> 4 n� �'\j <br /> 5 <br /> G <br /> �� ✓ <br /> 8 k� � ak � I <br /> 10 �+61 <br /> 11 / <br /> 0 n d <br /> L <br /> 12 <br /> 13 ����5 Y� ,�'� ✓ <br /> H:Un Service Sign-In shcos.doe 1`� I <br />