1. Incident identification

An incident occurs at the practice.

• Practice staff

1. Take any immediate action required to reduce, minimise, or treat harm:
   • Send for whatever help is necessary.
   • Provide whatever help is needed to the victim and protect them and others from further harm, e.g. by preventing access to the hazard if it is a workplace health and safety incident.
2. If it is any other type of incident or significant event, verbally report it to the nurse manager and practice manager.
3. Fill in an incident form with:
   • what happened
   • when it happened
   • who was involved
   • any immediate action taken.

   Do not include identifying details of patients or staff members.

4. Forward it to the practice manager.

    

2. Incident management

Manage the incident.

• Practice manager
• Nurse manager

1. Determine the type of event – is it work-related or related to the provision of health care?
2. If it is work-related and is notifiable:

   A notifiable injury or illness includes:

   • any of the following injuries or illnesses that require the person to have immediate treatment (other than first aid):
     • the amputation of any part of his or her body
     • a serious head injury
     • a serious eye injury
     • a serious burn
     • the separation of his or her skin from an underlying tissue (such as degloving or scalping)
     • a spinal injury
     • the loss of a bodily function
     • serious lacerations.
   • an injury or illness that requires, or would usually require, the person to be admitted to a hospital for immediate treatment
   • an injury or illness that requires, or would usually require, the person to have medical treatment within 48 hours of exposure to a substance
   • any serious infection (including occupational zoonoses) to which the carrying out of work is a significant contributing factor, including any infection that is attributable to carrying out work:
     • with micro-organisms; or
     • that involves providing treatment or care to a person; or
     • that involves contact with human blood or bodily substances; or
     • that involves handling or contact with animals, animal hides, animal skins, animal wool or hair, animal carcasses, or animal waste products; or
     • that involves handling or contact with fish or marine mammals.

   Any of these injuries or illnesses that happen to an employee, volunteer, or visitor must be notified to WorkSafe.

   A notifiable incident is any unplanned or uncontrolled incident in relation to a workplace that exposes a person to serious risk to their health and safety arising from an immediate or imminent exposure to a hazard, including:

   • an escape, a spillage, or a leakage of a substance
   • an implosion, explosion, or fire
   • an escape of gas or steam, or pressurised substance
   • an electric shock
   • the fall or release from a height of any plant, substance, or thing.

   For a full list of notifiable incidents, see the definition in the Act.

   A notifiable event is any of the following events that arise from work:

   • the death of a person
   • a notifiable injury or illness
   • a notifiable incident.
   • Report it to WorkSafe NZ, 0800 030 040, as soon as possible.
   • Make sure the incident scene is not disturbed until advised by the relevant organisation. If it is necessary to disturb the scene to help an injured person, take photographs first.
3. If it is related to the provision of health care, use a risk matrix to help determine the risk rating of the incident and the level of investigation required.

   HQSC's Severity Assessment Criteria table is designed for use in health care.

4. Investigate the incident within 10 days:
   • Include all staff involved in the investigation and review.
   • Gather facts relating to the incident (may include photographs of the scene and information from witnesses).
   • Investigate contributory factors such as equipment, current policies, staff, the patient, and the environment to determine what happened, how it happened, why it happened.
   • Analyse and understand the sequence of events leading to the incident.
   • Identify any hazards involved and assess any controls already in place, recommending improvements and corrective actions where necessary.
   • Examine any omissions and errors, poor communication, or failure to comply with current policies.
   • Add details of the investigation to the incident form.
5. Determine what changes or corrective actions are required to prevent it happening again.

   Agree recommendations about what should be done to prevent similar incidents.

6. Complete the rest of the incident form.
7. Provide feedback to the staff involved in the incident.
8. Review and discuss any changes to procedures with the practice team.

3. Communication

Communicate with the patient and staff.

• Practice manager
• Nurse manager

1. If the event involved a patient, communicate openly and fully:
   • Advise the patient of any actions taken to remedy the harm suffered by them or to prevent any harm occurring because of the event.
   • Advise the patient if the event is reported to an external authority.
2. Communicate and explain any changes to processes or procedures, and the need for them, to staff.

4. Documentation

Record all incident details

• Practice manager

1. Record the incident details in the incident reporting register.
2. Prepare any documentation necessary to accompany the incident forms.
3. Document any corrective actions or changes to processes that need to be implemented.
4. Document any follow-up.