Wake North Carolina Injury Report Form
Description
How to fill out Injury Report Form?
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FAQ
Include details about what happened before the incident, the incident itself, and actions that were taken immediately after. If you are writing down your opinion of what caused the incident or what you think happened, be sure to note that it is an assumption.
4 Steps for Writing an Effective Accident Report Date, time and specific location of incident. Names, job titles and department of employees involved and immediate supervisors. Names and accounts of witnesses. Events leading up to incident. Specifically what the employee was doing at the moment of the accident.
Facts related to the incident include: The Basics. Identify the specific location, time and date of the incident.The Affected. Collect details of those involved and/or affected by the incident.The Witnesses.The Context.The Actions.The Environment.The Injuries.The Treatment.
What Does an Incident Report Need to Include? Type of incident (injury, near miss, property damage, or theft) Address. Date of incident. Time of incident. Name of affected individual. A narrative description of the incident, including the sequence of events and results of the incident. Injuries, if any.
The most important thing for employees to know is that any time you are injured on the job, you should report the injury immediately to a supervisor, in writing if possible. Some states require that notice to the employer be made in writing, while others allow a verbal notice.
DO include direct quotes from residents (disrespectful words, actions, etc.). DO NOT simply write, residents were rude. Be as descriptive as that helps provide an accurate picture of was observed. DO use paragraphs to break up the narrative of events. DO NOT write lengthy blocks of text.
The key tasks to mention in the workflow includes notification of the incident, identification of responsible, interviews, investigation and analysis, conclusion, sharing learnings and implementation.
Ensure that all essential questions (what, where, when, why, and how) are covered in the incident report. Record not only the people who were injured and what caused the accident to happen, but also include details such as people who witnessed and reported the incident or those who will conduct an investigation.
Keep in mind that these 3 considerations are not to be confused with the 3 requirements for writing an incident report: The report must be factual and without assumption. An incident report must be accurate and without bias. The incident report must be complete.
