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Incident Reports
Table of Contents
(ctrl+click on text to go directly to section)
Function/Purpose 1
When to Report 1
OSHA Recordkeeping Requirements 1
Who Should Report 2
Employee Responsibility 2
Supervisor Responsibility 2
Tips for Reporting Incidents 3
Instructions for Completion of Form 3
Incident/Complaint Report 4
Laboratory Incident Report 6
Post-Exposure Incident Source Individual Consent Form 8
Post-Exposure Incident Exposed Employee Consent Form 9
INCIDENT REPORTS
Function/Purpose
An incident report is not part of the patient’s chart, but it may be used later in litigation. A report has two functions:
It informs the administration of the incident so management can prevent similar incidents in the future.
It alerts administration and the facility’s insurance company to a potential claim and the need for investigation.
Regulations issued under OSHA require all employers with more than ten employees at any time during the previous calendar year to maintain records of recordable occupational injuries and illnesses.
When to Report
Incidents that must be reported and documented include:
Exposure Incidents: skin, eye, mucous membrane or parental contact with blood or other potentially infectious materials that may result from the performance of an employee’s duties.
Accident, Injury: patient, visitor, employee slips or falls, or other incident, which results or may result in injury.
Event, Behaviors, or Actions: incidents that are unusual, contrary to agency policy or procedure or which may result in injury.
Vaccine Adverse Event Reporting System: reaction to vaccine administered at agency (use VAERS form, instructions and sample in Immunization section).
Medication reaction: reaction to any drug administered at or provided by health department. Complete Adverse Drug Reaction Form. For more information,
call 1-800-332-1088.
Property damage or missing articles.
Administration of wrong medication or vaccine.
Improper
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