Ball State University
School of Nursing

Verification of Training in
Standard Precautions for Registered Nurses

        According to the Universal Precautions Rule 410 1AC 1-4 under Public Law 123-1988:

“An employer shall provide training and the necessary equipment to each employee and

student trainee who has duties that require the employee to have direct contact with blood

or body fluids in the scope of the employee’s employment.” This training must include

instruction in the procedures “Standard Precautions."

        Because nursing students may have direct contact with blood and other body fluids, the

School of Nursing is requiring training in Standard Precautions. This form will be retained in

the School of Nursing office as documentation of training in Standard Precautions.

This is to verify that ______________________________ received training in Standard

Precautions on ____ / ____ / ________ (mm/dd/yyyy)

at _______________________(Agency Name).

Signature (Agency Representative) _____________________________

(Title) _____________________________________

(Date) _________________________