Annual Safety Training Review
The following questions are to be completed by each employee as part of his/her annual in-service
training. Once completed, you will review this completed review with your supervisor and any questions
or uncertainties should be resolved at this time. This questionnaire will be kept by your supervisor as
part of your employee departmental record.
Hazard Communication Training
(Please view the Right to Know Video on Hazardous Materials and answer the following questions.)
1.
Labels must:
a)
b)
c)
d)
2.
centrally within the department in which the chemical is used
in the main lobby
at the Department of Environmental Affairs
both a and b
both a and c
Under the Hazard Communication Standard, training is required:
a)
b)
c)
d)
e)
4.
identity of the contents
appropriate hazard warnings
above name and address of the manufacturers
above
Material Safety Data Sheets are located:
a)
b)
c)
d)
e)
3.
state the
state the
state the
all of the
by the Environmental Protection Agency
by the National Institute for Occupational Safety and Health
by the Occupational Safety and Health Administration
a and c
none of the above
Mark True or False to the left of each statement.
Contractors are not responsible for reviewing and understanding the BWH Hazard Communication program.
Secondary containers do not require labels.
The manufacturer of a particular chemical is not required on the MSDS.
Department heads are responsible for obtaining and maintaining MSDS’s.
Fire Training
(Please view the Fire/Safety/Security Video and refer to the BWH Blue Book to answer the following questions.)
1.
You have just discovered a fire. Your first reaction should be to:
a)
b)
c)
2.
You hear a nurse call out CODE RED and a room number. You should:
a)
b)
c)
3.
Rescue the patient
Pull the fire alarm and call out CODE RED and room location
Call out CODE RED while proceeding to pull the fire alarm
Pull the alarm nearest you and call 2-6555 on the hospital phone
Call back an acknowledgement and start closing doors
Call back an acknowledgement and go to the room indicated
The two fire alarm pull boxes nearest your work area are: (specific to your location)
a)
b)
c)
Both located within the unit confines
One located within the unit, the other outside the unit
Both located outside the unit
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4.
When calling 2-6555 to report a fire, the three things you should say in their proper order are:
a)
b)
c)
CODE RED, your name, fire location
Your name, CODE RED, fire location
CODE RED, fire location, your name
Fire Extinguisher Training
(Please refer to the BWH Blue Book and answer the following questions.)
1.
One should always aim the extinguisher discharge:
a)
b)
c)
2.
Which type of extinguisher(s) should be used for a fire involving flammable liquids, oils, and flammable gases?
a)
b)
c)
3.
4.
Into the flames
Between you and the fire so you can get close enough to fight the fire
At the base of the fire
pressurized water
carbon dioxide
dry chemical
You should attempt to extinguish a fire:
T or F
only in the case of a small, manageable fire
T or F
instead of pulling the fire alarm
T or F
in all code red situations
True or False (Circle)
T or F
Pull the pin all the way out of the extinguisher handle.
T or F
Aim the hose or nozzle into the flames.
T or F
Squeeze the handle all the way closed to discharge extinguishing agent.
T or F
Sweep from side to side, continuing to aim at the base of the fire.
Disaster Training
(Please read the section on Internal/External Disasters in the BWH Blue Book and answer the following questions.)
1.
Match the following codes with their meaning:
Pink
Grey
White
Blue
Red
Amber
2.
Internal event in which patients, staff and visitors are at risk of injury or an event which may lead to a decrease
or discontinuation of services provided by the hospital.
a)
b)
c)
d)
3.
Fire
Bomb Threat
Infant Abduction
Disaster (Internal or External)
Security Emergency
Cardiac Arrest
External Disaster (Code Amber, External)
Internal Disaster (Code Amber, Internal)
Stat Emergency (Code Green)
None of the above
Which of the following could constitute an Internal Disaster (Code Amber, Internal):
a)
b)
c)
A severe weather condition causing damage to BWH facilities or making it difficult for staff to get to work.
A plane crash at Logan Airport resulting in a significant influx of patients
Loss of power affecting the main campus of BWH
d) A and C
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Infection Control/OSHA Post-Video Questions
(Please view the Infection Control/Bloodborne Pathogen Video and answer the following questions. Also, the BWH
Blue Book contains the information necessary to answer the following questions.)
1.
If you get stuck with a needle, cut yourself, get blood in your eyes or mouth, you must do which of the
following:
a)
b)
c)
d)
e)
f)
g)
2.
Notify your supervisor
Wash the injury
Fill out an accident report
Report to Occupational Health
Page the STIK Beeper (37845), (3-STIK)
All of the above
It depends on the source of the exposure
If Occupational Health is closed and you need to report a needle stick/sharps exposure, you should do so
immediately (within 1 to 2 hours) by:
a)
b)
c)
Paging the STIK Beeper (3-STIK) and going to the emergency room
Leaving a message on the Occupational Health Service answering machine
Going to Occupational Health Service when it opens
3.
Hepatitis B virus, Hepatitis C virus, and HIV (AIDS virus) can be transmitted through accidental needle stick, cut
with a sharp, or by contact with blood on open cuts, chapped skin, eyes or mouth. True or False.
4.
Hepatitis B vaccine is recommended for anyone whose job involves contact with blood. True or False
5.
Are you aware that Occupational Health Service will provide the Hepatitis B vaccine for free?
Yes or No
6.
When should you wash your hands?
a)
b)
c)
d)
e)
f)
7.
Gloves must be worn:
a)
b)
c)
d)
8.
Whenever you are doing something where you might come in contact with blood or body fluids.
Whenever you care for a patient on Contact Precautions
All the time
Both a and b
Either goggles or prescription glasses with solid side shields, and mask or chin length face mask must be worn:
a)
b)
c)
9.
After patient contact
Before leaving a lab
After removing your gloves
Before eating
All of the above
Never
If the patient has AIDS or HIV infection
Whenever you are doing something that may splash blood or body fluids into your face
Only if you want them
Needle safety products such as: safety IV catheters, sheathed butterfly needles, sheathed syringes, and
recessed needles should be used in place of standard needles whenever possible. True or False.
10. Needle safety products and personal protective equipment (face protection, gloves, gowns) are available in
every department. Your supervisor should show you their location.
Where is the personal protective equipment located in your work area? ______________________
11. Special signs, labels and containers are used to identify regulated medical waste. The following are used at
BWH:
a)
b)
c)
Orange/orange-red biohazard labels
Red trash bags and containers
Both of the above
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12. Task sheets list the specific precautions you should use for your activities. You should review them if you have a
question. Dept. of Nursing task sheets have been incorporated into The Clinical Practice Manual.
Do you know where your department’s task sheets are kept? Yes or No.
Tuberculosis Questionnaire
(Please read the section on TB in the BWH Blue Book and answer the following questions.)
1. TB is spread by inhaling germs, which have been released into the air from a person with active tuberculosis.
True or False
2.
Patients with suspected or confirmed respiratory tract TB must be admitted to a:
a)
b)
c)
3.
When caring for/entering a room of a patient with respiratory tract TB, the following should be worn:
a)
b)
c)
d)
4.
Gloves
N95 Mask (3M) or powered air-purifying respirator (PAPR).
Gown
Surgical Mask
Patients with suspected or confirmed respiratory tract TB must be placed on the following type of precautions:
a)
b)
c)
5.
Positive Air Pressure Room
Negative Air Pressure Room
None of the Above
Contact Precautions
Droplet Precautions
Airborne Precautions
A TB patient should only travel to another area for diagnostic tests if absolutely necessary. In such a case, the
patient must wear:
a)
b)
Surgical mask
Respirator mask
6.
A TB skin test is performed to determine if a person has been infected with TB. True or False.
7.
Some common symptoms of TB are:
A)
B)
C)
D)
E)
Night sweats
Weight loss
Prolonged cough
Coughing up blood
All of the above
Patient Safety/Risk Management Questionnaire
(Please read the sections on Patient Safety and Risk Management in the BWH Blue Book and answer the
following questions.)
1.
You observe a patient who trips and falls over his IV pole. The patient is not injured. This would be considered:
A)
B)
C)
D)
2.
a near miss
a sentinel event
an adverse patient event
an adverse drug event
After witnessing an adverse patient event, you should:
A) do nothing if the patient doesn’t appear hurt
B) alert the nurse manager or appropriate supervisor
C) file an adverse event report
D) both b and c
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3.
You should file an adverse event report for:
A)
B)
C)
D)
4.
When filing an adverse event report, you should include:
A)
B)
C)
D)
5.
a near miss event in which you catch the problem before it reaches the patient
an adverse patient event
an adverse drug event
all of the above
the facts of the event; what you saw, heard and did
a quote from what a patient or visitor says about an incident if possible
the name of someone to blame
both a and b
The goal of the Risk Management Department / Patient Safety Team is to investigate near misses and adverse
events and identify systems or processes that can be improved, not to assign blame to an individual.
True or False (please circle)
6. What happens to an adverse event report when you file it? (This information cannot be found in the BWH Blue
Book. Your supervisor can help answer this question.)
__________________________________________________________
__________________________________________________________
__________________________________________________________
__________________________________________________________
__________________________________________________________
__________________________________________________________
__________________________________________________________
These quizzes were corrected and reviewed with the supervisor. Yes ____
Name:
____________________________________
Employee ID: ____________________________________
Department: ____________________________________
Training Date:
____________________________________
* These quizzes should be maintained as part of the employee’s departmental records.
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