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South Austin Medical Center
South Austin Medical Center
Anonymous

South Austin Medical Center

Risk Assessment

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Free South Austin Medical Center Checklist

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Information

  • Document No.

  • Audit Title

  • Client / Site

  • Conducted on

  • Prepared by

  • Location

  • Personnel

Key:

O-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. Enforce 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 Predparedness

  • Sharps/ Needle Exposure

  • Score.
    Probability. 1-10
    Risk. 1-10
    Preparedness. 1-10
    Total

  • Add media

  • TB Exposure

  • Score.
    Probability. 1-10
    Risk. 1-10
    Preparedness. 1-10
    Total

  • Add media

  • Chemical Exposure

  • Score.
    Probability. 1-10
    Risk. 1-10
    Preparedness. 1-10
    Total

  • Add media

  • Lasers in use

  • Score.
    Probability. 1-10
    Risk. 1-10
    Preparedness. 1-10
    Total

  • Add media

  • Blood and Body Fluid Exposure

  • Score.
    Probability. 1-10
    Risk. 1-10
    Preparedness. 1-10
    Total

  • Add media

  • X-ray Exposure

  • Score.
    Probability. 1-10
    Risk. 1-10
    Preparedness. 1-10
    Total

  • Add media

  • Falls

  • Score.
    Probability. 1-10
    Risk. 1-10
    Preparedness. 1-10
    Total

  • Add media

  • Ergonomics

  • Score.
    Probability. 1-10
    Risk. 1-10
    Preparedness. 1-10
    Total

  • Add media

  • Fire

  • Score.
    Probability. 1-10
    Risk. 1-10
    Preparedness. 1-10
    Total

  • Add media

  • ADA Violations

  • Score.
    Probability. 1-10
    Risk. 1-10
    Preparedness. 1-10
    Total

  • Add media

  • Assault

  • Score.
    Probability. 1-10
    Risk. 1-10
    Preparedness. 1-10
    Total

  • Add media

  • Theft

  • Score.
    Probability. 1-10
    Risk. 1-10
    Preparedness. 1-10
    Total

  • Add media

  • Suicide

  • Score.
    Probability. 1-10
    Risk. 1-10
    Preparedness. 1-10
    Total

  • Add media

  • HIPPA

  • Score.
    Probability. 1-10
    Risk. 1-10
    Preparedness. 1-10
    Total

  • Add media

  • Utilities

  • Score.
    Probability. 1-10
    Risk. 1-10
    Preparedness. 1-10
    Total

  • Add media

Comments

  • Select date

  • Add signature

Forwarding instructions

Send completed copy to Facility Engineering: Attention Safety

E-Mail completed report to: Michael.huff@stdavids.com Keep a copy for your Department records

South Austin Medical Center
Anonymous

South Austin Medical Center

Risk Assessment

Use this Template
The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.

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