CON Incident Report

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Incident Report Subsection: 4.2.5
Section 4.0 - Faculty Policies Originating Date: July 1991
Responsible Reviewing Agency:
Executive Council

Related Documents:
UNMC Safety Policy Number 2000
Incident Reporting and Work Injury Care
Incident Report Form
Near-Miss/Potential Hazard Form
UNMC Student Handbook
Revised: August 1998
Revised: December 2006
Revised: January 2015 (changes)
Revised: November 2023 (changes)


Establishes requirement for written confidential reports of all unusual incidents that do or do not result in injury.


Applies to all employees, students, and volunteers.


Incident: An incident is any unusual occurrence which is not consistent with the routine operation of the University of Nebraska Medical Center or an agency in which students are assigned for clinical learning experiences. An incident is defined as an occurrence which may or did cause harm, involves possible negligence, or requires some immediate consideration or action by the supervising faculty member or administration. Examples include, but are not limited to: accidents, medication errors, accidental exposure to body fluids, theft of property or other potentially dangerous occurrences.

Near-Miss Incident: A near-miss incident is an unsafe condition that does not result in injury, does not involve patients, and does not occur in a clinical area.

Incident Report Form: The incident report provides prompt, complete and accurate documentation of the details related to an incident in order to: assure continuous quality improvement, identify trends or potential problems, document occurrences to assess liability, process any necessary insurance claims, and provide the information necessary to carry out corrective action and develop programs for prevention

Near-Miss/Potential Hazard Form: The near-miss/potential hazaard from allows for online reporting of unsafe conditions that have the potential for risk, injury or damage.


In keeping with the policy of the University of Nebraska Medical Center (UNMC), it is the policy of the College of Nursing (CON) that there be written confidential reports of all unusual incidents occurring at any of the college's divisions, in agencies where students are assigned for learning experiences, or en route to or from learning experiences. The appropriate UNMC form as listed above is to be completed for faculty and students even if there is a separate incident report required by the agency in which an incident occurs.

The appropriate form should be completed by the person who experienced the incident or by the supervisor or supervising faculty member if individual is unable to complete. Forms should be completed within 24 hours of the incident occurrence and the individual’s supervisor and/or division assistant dean should be notified. If the incident occurs at a clinical agency, the division assistant dean should be informed.

Incident Report or Near-Miss/ Potential Hazard form are not to be copied.

Completed Incident Report form will be submitted to UNMC Human Resources when an employee is involved and to UNMC Environmental Health and Safety when a student or volunteer is involved..Near-Miss/Potential Hazard form is completed and submitted online.

Faculty should consult the UNMC Student Handbook and the UNMC Safety Policy for follow-up procedures.