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Policy 3.4: Clinical Incident & Exposure Reporting  

Applies to: A/BSN, DNP, Certs, or other students engaged in clinical or practicum settings.

I. Policy Statement

The School of Nursing (SoN) requires prompt reporting of all clinical incidents, errors, occupational exposures, and near-miss events that occur during coursework or clinical training.

  • Incidents involving patients (e.g., patient harm, risk of harm, HIPAA violations, or drug diversion) must be reported for patient safety, regulatory compliance, and possible escalation to the Washington State Board of Nursing (WABON) under WAC 246-840-513.
  • Incidents involving students (e.g., injuries, illnesses, exposures, or near-misses) must be reported for student safety, access to follow-up care, and compliance with University and EH&S requirements.

The SoN applies a Just Culture model for incident review, focusing on accountability, learning, and system improvement rather than blame.

Failure to report may result in review under School of Nursing Policy 1.1: Academic Performance & Progress and/or the UW Student Conduct Code.

II. Process: Clinical Incidents Involving Patients

Clinical incidents include events that result in patient harm, create an unreasonable risk of patient harm, involve diversion of legend or controlled substances, or constitute HIPAA violations.

Definitions (per WAC 246-840-513):

  • Unreasonable risk of harm: Act or omission below the standard of care, creating patient risk whether or not harm occurred.
  • Patient harm: Anything that impairs/adversely affects patient health, safety, or well-being, including abuse, neglect, or exploitation.
  • Diversion: Misappropriation of legend drugs or controlled substances.

Steps to take

Step 1: Immediate Notification

  • Student notifies clinical faculty or preceptor immediately.
  • Ensure patient safety as first priority.

Step 2: Site Response

  • Follow the clinical site’s internal reporting procedures.

Step 3: SoN Reporting

Step 4: Follow-Up

  • Students may be temporarily removed from clinical activities, pending review.
  • Faculty and ADAA ensure follow-up is documented in the student record.

III. Process: Incidents Involving Students

Examples: illness, injury, bloodborne pathogen exposure, fire, property damage, near-miss.

Step 1: Immediate Care and Notification

  • Student seeks immediate care (ER, employee health, 911 if needed).
  • For BBP exposures: wash/flush and contact UW EH&S Bloodborne Pathogen Response (206-221-7770).
  • Faculty/preceptor ensures group supervision is maintained; if the instructor must leave the site, all students must leave unless another UW faculty assumes responsibility.

Step 2: Site Response

  • Follow the clinical site’s incident procedures.

Step 3: University Reporting

  • All education-related injuries, illnesses, exposures, fires, property damage, and near-miss events, including but not limited to bloodborne pathogen exposures, must be reported in the UW Online Accident Reporting System (OARS) within 24 hours of the incident.
  • Student and supervising faculty complete the (OARS) report within 24 hours for all incidents.
  • Immediate EH&S notification is required for:
    • In-patient hospitalization, amputation, loss of eye, or fatality
    • Recombinant/synthetic DNA/RNA exposures or spills
    • Radioactive material or laser exposures
  • Students experiencing a BBP exposure follow the UW EH&S Bloodborne Pathogen exposure process in addition to completing required OARS and site reports.
  • Students must also comply with all clinical site-specific reporting requirements.
  • During EH&S business hours (8:00 a.m. to 5:00 p.m., Monday–Friday), call 206-543-7262.
  • Outside business hours, call the UW Police Department (206-685-8973) to reach EH&S on-call staff.
  • For OARS assistance, email injury@uw.edu

Step 4: SoN Reporting

Step 5: Follow-Up

    • Student complies with all recommended testing, treatment, and monitoring.
    • Student support and referrals (e.g., UW Counseling Center, Hall Health) are encouraged.

IV. RACI: Roles and Responsibilities

Activity Student Faculty/ Preceptor Program Official (ADAA/PD) EH&S
Patient-Related Incidents
Immediate notification & site report R A I
Complete SoN Clinical Incident Form I A/R C
Escalation to WABON (if required) I C A/R
Student-Related Incidents
Seek immediate care & complete OARS A/R A/R I I
Complete SoN Clinical Incident Form I A/R C I

RACI Legend:

  • R = Responsible: Performs the task
  • A = Accountable: Ultimately answerable
  • C = Consulted: Provides input
  • I = Informed: Kept up to date

Related Policies & References

Last updated: September 2025