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JP- -- <br /> *tors Hospital D rtment. In-Service Sign In S et ADAHN <br /> Of Manteca <br /> .aC.O. i. All fl s must be 'filled in — PLEAS • RINT <br /> CLASS TITLE <br /> Hazardous Waste Management <br /> DATE May 1St — 10tH <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 Ail clinical staff <br /> TEACHING METHODS: Lecture Self study Discussion Demonstration Video <br /> Circle all that apply Resourc n er <br /> DEPARTMENTS ICU, MS, SS, erinatal, OR, ED <br /> LEARNING OBJECTIVES t Proper " ation of hazardous waste <br /> (clearly 2. Proper identification of waste disposal containers <br /> 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 Technology New/Revised Policy Procedure <br /> PARTICIPANT Post test Return demo Competency Re-monitor <br /> EVALUATION METHOD I QI Change in clinical practice OTHER <br /> PRINT NAME (First & Last) DEPT EMP Contract/ ADMIN <br /> (� Kon-Em <br /> 3 <br /> 4 <br /> V0 Uk"'k ffiaa5 <br /> Y r� <br /> 6 f I " t <br /> 8 <br /> lens <br /> 9 <br /> 10 <br /> 11 <br /> T- <br /> 12 <br /> 13 <br /> 1.o uisS'a si�ph�n s�1 r��� <br /> HAIn Service Sign-In sheets.doc t <br />