Memo 25: Management of Clinical Incidents Involving Patients or Students
Should an incident occur in the course of clinical training or while attending courses at the University of Washington, the student is to immediately contact their UW clinical faculty. This includes all medication errors and HIPAA violations. “Clinical Incident Reporting: What Students Need to Know” (2 minutes) is linked in every Canvas course and shared during student orientation.
Reporting a Clinical Incident that Resulted in Patient Harm, Risk of Patient Harm, Diversion of Legend Drugs or Controlled Substances, or HIPAA Violations
For any clinical incident that “resulted in patient harm, an unreasonable risk of patient harm, or diversion of legend drugs or controlled substances,” including HIPPA violations, the faculty who is informed or aware will complete an internal SoN Clinical Incident Reporting form. The individuals identified on the form will be contacted by an OSAA Program Official who will facilitate a process that may result in submission to the Washington State Board of Nursing, as required by WAC 246- 840-513. The process is based on principles of the Just Culture Model.
The following definitions are in the Washington State Board of Nursing Incident Report form:
- Unreasonable risk of harm: An act or failure to act, which is below the standard of care for what a reasonably prudent nurse would do in similar circumstances, thereby creating a risk of harm to the patient, whether or not actual harm resulted.
- Patient harm: Anything that impairs or adversely affects the health, safety, or well-being of the patient. Harm includes physical, mental, emotional, and sexual abuse, exploitation, neglect, or abandonment.
- Alleged diversion of legend or controlled substances: A claim or assertion that an individual misappropriated any legend drug or controlled substance.
All nursing students must complete UW Health Insurance Portability and Accountability Act (HIPAA) training. This training is done via a secure website and lasts approximately ninety minutes. You may be required to take additional HIPAA modules at certain clinical sites. Violations of HIPAA regulations must be reported as per the above guidelines.
For any incident that occurs at a clinical training site, students must additionally adhere to any reporting policies set forth by their clinical site or agency.
Reporting an Injury, Illness, Exposure, Fire, Property Damage, or Near-Miss Incident Involving a UW Student
All education-related injuries, illnesses, exposures, fires, property damage, and near-miss events, including, but not limited to, blood-borne pathogen exposure, must be reported via the UW Online Accident Reporting System (OARS) within 24 hours of the incident; however, the following incidents require immediate notification to Environmental Health & Safety (EH&S):
- In-patient hospitalization, amputation, loss of an eye, or fatality
- Recombinant/synthetic DNA/RNA exposure or spill
- Radioactive material spill, exposure, accidental exposure from a radiation-producing device or laser
During EH&S business hours (8:00 a.m. to 5:00 p.m., Monday to Friday), call 206.543.7262. Outside of EH&S business hours, call the UW Police Department at 206.685.8973 to reach EH&S on-call staff.
If you have issues submitting your OARS report, please contact EH&S at injury@uw.edu.
Students exposed to BBP should follow the UW’s campus-wide UW Environmental Health & Safety Bloodborne Pathogens guidance. Please also refer to SoN Memo 45: BBP Exposure Policy.
Students experiencing an injury and/or BBP exposure at all clinical sites and agencies, or during the course of educational training at the School of Nursing should complete reporting per the guidelines above.
For any incident that occurs at a clinical training site, students must additionally adhere to any reporting policies set forth by their clinical site or agency.
Faculty/Instructor responsibility in the event of a student emergency
- The instructor’s primary obligation at the clinical site is the supervision of the group of students. If a student becomes ill or injured, your role is to direct the student to treatment as necessary, ensuring that supervision of the other students is ongoing. You must follow the policy and procedures of the agency. This may include: sending the student to the ER of the institution, sending the student to the employee health clinic, calling a cab so that a student can get to a care provider of choice, calling a code, or calling 911.
- If the instructor leaves the agency, all students in the section must leave the agency, as they must be supervised at all times. Students should be instructed to report off, refrain from giving any patient care, and leave immediately. If there is a UW faculty member on-site who assumes responsibility to supervise your group of students, you may assign students to report to that faculty member in your absence.
- Once the immediate needs of the situation have been met, the instructor must complete the UW Nursing Student Clinical Incident/Injury form, send a copy to the Office of Student and Academic Affairs, Box 357260, and send the original to Environmental Health & Safety, Hall Health Center, Box 354400, Seattle, WA, 98195. The agency may also request you to fill out their incident report.
- Inform the Associate Dean for Student and Academic Affairs sonadaa@uw.edu of the incident and the actions you took.
Updated September 2024 – Office of Student and Academic Affairs