Key:
0-2 Very Low Risk. No extraordinary actions required. Monitor
3-4 Low Risk. Educate. Enforce existing policies. Emphasize during EOC surveys. Monitor
5-9 Moderate Risk. Educate. Enforcen existing policies. Emphasize during EOC surveys. Monitor
10 > High Risk. Educate.Enforce/Develop effective policies. Emphasize during EOC surveys. Monitor
To get total multiply: Probability x Risk x Preparedness
Sharps/Needles Exposure
Probability
High - 3
Medium - 2
Low - 1
N/A - 0
Risk
Life Threat - 5
Health Safety - 4
High Disruption - 3
Moderate Disruption - 2
Low Disruption - 1
Preparedness
Poor - 3
Fair - 2
Good - 1
Total:
TB Exposure
Probability
High - 3
Medium - 2
Low - 1
N/A - 0
Risk
Life Threat - 5
Health Safety - 4
High Disruption - 3
Moderate Disruption - 2
Low Disruption - 1
Preparedness
Poor - 3
Fair - 2
Good - 1
Total:
Chemical Exposure
Probability
High - 3
Medium - 2
Low - 1
N/A - 0
Risk
Life Threat - 5
Health Safety - 4
High Disruption - 3
Moderate Disruption - 2
Low Disruption - 1
Preparedness
Poor - 3
Fair - 2
Good - 1
Total:
Lasers in Use
Probability
High - 3
Medium - 2
Low - 1
N/A - 0
Risk
Life Threat - 5
Health Safety - 4
High Disruption - 3
Moderate Disruption - 2
Low Disruption - 1
Preparedness
Poor - 3
Fair - 2
Good - 1
Total:
Blood & Body Fluid Exposure
Probability
High - 3
Medium - 2
Low - 1
N/A - 0
Risk
Life Threat - 5
Health Safety - 4
High Disruption - 3
Moderate Disruption - 2
Low Disruption - 1
Preparedness
Poor - 3
Fair - 2
Good - 1
Total:
X-ray Exposure
Probability
High - 3
Medium - 2
Low - 1
N/A - 0
Risk
Life Threat - 5
Health Safety - 4
High Disruption - 3
Moderate Disruption - 2
Low Disruption - 1
Preparedness
Poor - 3
Fair - 2
Good - 1
Total:
Falls
Probability
High - 3
Medium - 2
Low - 1
N/A - 0
Risk
Life Threat - 5
Health Safety - 4
High Disruption - 3
Moderate Disruption - 2
Low Disruption - 1
Preparedness
Poor - 3
Fair - 2
Good - 1
Total:
Ergonomics
Probability
High - 3
Medium - 2
Low - 1
N/A - 0
Risk
Life Threat - 5
Health Safety - 4
High Disruption - 3
Moderate Disruption - 2
Low Disruption - 1
Preparedness
Poor - 3
Fair - 2
Good - 1
Total:
Fire
Probability
High - 3
Medium - 2
Low - 1
N/A - 0
Risk
Life Threat - 5
Health Safety - 4
High Disruption - 3
Moderate Disruption - 2
Low Disruption - 1
Preparedness
Poor - 3
Fair - 2
Good - 1
Total:
ADA Violations
Probability
High - 3
Medium - 2
Low - 1
N/A - 0
Risk
Life Threat - 5
Health Safety - 4
High Disruption - 3
Moderate Disruption - 2
Low Disruption - 1
Preparedness
Poor - 3
Fair - 2
Good - 1
Total:
Assault
Probability
High - 3
Medium - 2
Low - 1
N/A - 0
Risk
Life Threat - 5
Health Safety - 4
High Disruption - 3
Moderate Disruption - 2
Low Disruption - 1
Preparedness
Poor - 3
Fair - 2
Good - 1
Total:
Theft
Probability
High - 3
Medium - 2
Low - 1
N/A - 0
Risk
Life Threat - 5
Health Safety - 4
High Disruption - 3
Moderate Disruption - 2
Low Disruption - 1
Preparedness
Poor - 3
Fair - 2
Good - 1
Total:
Suicide
Probability
High - 3
Medium - 2
Low - 1
N/A - 0
Risk
Life Threat - 5
Health Safety - 4
High Disruption - 3
Moderate Disruption - 2
Low Disruption - 1
Preparedness
Poor - 3
Fair - 2
Good - 1
Total:
HIPAA
Probability
High - 3
Medium - 2
Low - 1
N/A - 0
Risk
Life Threat - 5
Health Safety - 4
High Disruption - 3
Moderate Disruption - 2
Low Disruption - 1
Preparedness
Poor - 3
Fair - 2
Good - 1
Total:
Comments Forwarding Instructions
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Risk Assessment
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