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What Information Do You Put in an Incident Report? Date, time, and facility location. Where the incident occurred. Incident type. Name of the person(s) affected by the incident. Witnesses or names and titles of other involved persons. Written summary of what happened, which can include:
A patient incident report should include the basic information about the incident: the who, what, where, when and how. You should also add recommendations on how to address the problem to reduce the risk of future incidents.
The key to a good incident report is completeness and accuracy, and that means documenting as much information as possible: Date of incident. Time of incident. Type of incident. Location of incident. Name of individual(s) affected. Name of witnesses to the incident. Witness reports. A detailed description of the incident.
Three Incident Report Samples Type of incident (injury, near miss, property damage, or theft) Location (Address) Date/time of incident. Name. Name of supervisor. Description of the incident, including specific job site location, the sequence of events, and the results of the event. Whether or not proper PPE was being used.
Incident Report Sample Walkthrough: A Step-by-Step Guide Step 1: Provide Fundamental Information. ... Step 2: Take Note of Any Damages and Injuries. ... Step 3: Identify Affected Individual(s) ... Step 4: Identify Witnesses and Take Their Statements. ... Step 5: Take Action. ... Step 6: Close Your Report.