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HC NIRF 01 V10 Date issued: 03/05/2018NATIONAL INCIDENT REPORT FORM (NIRF) NIRF 01 PERSON NIMS record Number:Incident: An event or circumstance which could have, or did lead to unintended and / or.

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How to fill out the NIRF - 01 PERSON online

This guide provides a step-by-step approach to completing the National Incident Report Form (NIRF - 01 PERSON) online. It aims to assist users of all backgrounds in accurately reporting incidents while ensuring clarity and precision in the process.

Follow the steps to successfully complete the NIRF - 01 PERSON form.

  1. Press the ‘Get Form’ button to access the online version of the NIRF - 01 PERSON form and open it in your editing interface.
  2. Begin with Section A, which captures general incident details. Fill in the date of the incident, start with your first name, and then your surname. Specify the time of the incident using the 24-hour clock format, followed by the location, detailing the facility or area where the incident occurred.
  3. Continue in Section B to provide details about the person affected. Enter the date of birth and gender options (select male or female). Indicate whether the incident occurred offsite. In the 'Description of incident' field, describe the circumstances surrounding the incident.
  4. Select the division from the options provided. Depending on who was involved, tick the appropriate box indicating whether the affected individual was a service user, staff member, or another category. Each selection will direct you to additional relevant sections.
  5. For service user details, navigate to Section C, where you will need to input the healthcare record number and the category of the person affected.
  6. If applicable, provide details in Section D for staff members, agency staff, students, or volunteers involved in the incident, including employee number and lead clinician information.
  7. In Section E, if an external contractor was involved, fill in their company name and company number.
  8. Section F requires you to select the outcome at the time of the incident. Check the box that accurately describes the outcome and, if necessary, specify the body part affected.
  9. In Section G, specify the type of injury by ticking one option from the provided list.
  10. In Section H, indicate the type of hazard related to the incident by following the steps outlined in this section. Tick the appropriate options based on the nature of the incident.
  11. Proceed to Section I and document the immediate actions taken following the incident.
  12. Section K needs to be completed by the person discovering the incident, including their name, surname, and date notified.
  13. Fill in Section L for witness details, ensuring to include relevant contact information.
  14. Finalize your report by completing Sections L and M, as directed, ensuring all mandatory fields are filled out.
  15. Once you've completed the form, you have the option to save changes, download a copy for your records, print the form, or share it as needed.

Start filling out the NIRF - 01 PERSON form online today to ensure accurate and timely reporting.

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Accidents can be reported to the Health and Safety Authority in two ways, namely by hard copy, i.e. completing the Incident Report Form (IR1) and posting it to the HSA Contact Centre, Health and Safety Authority, The Metropolitan Building , James Joyce Street, Dublin 1, or reporting online, via the Health and Safety ...

The 4 main incident reports that should be on your list are: Near Miss Reports. Near misses are events where no one was injured, but given a slight change in timing or action, someone could have been. ... Injury and Lost Time Incident Report. ... Exposure Incident Report. ... Sentinel Event Report.

The rule of thumb is that any time a patient makes a complaint, a medication error occurs, a medical device malfunctions, or anyone—patient, staff member, or visitor—is injured or involved in a situation with the potential for injury, an incident report is required.

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.

The form should include the date and time of the incident, as well as the names of all those involved. The form should also list the sequence of events, and describe any injuries and damage sustained, only the essential information of the incident happened.

What should you include in an incident report? When & where did it happen? Your report should contain the date, time and location where the accident took place. ... Who were involved? ... What did they do? ... Why did it happen? ... Were there any witnesses? ... What is the extent of damage to a person or property?

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