***Please note*** This is NOT the form for incident reporting that is submitted to HR. If you are an employee of the university and obtain an injury through your work for PSU, you will need to submit an incident report through: https://www.pdx.edu/human-resources/policies-contracts-forms.
This Near-Miss and Incident input form consists of two pages. The first page is designed to collect the information necessary to describe the incident being reported. The second page is designed to help us understand how this incident relates to our lab safety program as well as other events in similar laboratories. These questions can also help stimulate thought about ways that the event could have been prevented or preparedness for it improved. After you submit the form, it will be reviewed by members of the EHS department and the Chemical Hygiene Committee for clarity.
Remember that response to any question is optional, however, the more information you provide, the more helpful the information we collect is likely to be to your fellow scientists on campus. This form is designed to help us gather data, not to get you or your lab mates in trouble. We may contact you with further questions or requests for clarification. At the end of the form there will be a section to include your e-mail address and your name, if you'd like to receive follow-up information on the event you reported. It is not required, but it would be appreciated. We greatly appreciate you providing us this information so that we may follow up with you in order to make any necessary improvements to our laboratory safety program.
Definitions:
Near Miss: an unintentional incident that could have caused damage, injury or death but was narrowly avoided. In the context of safety, a near miss may be attributed to human error, or might be a result of faulty safety systems or processes in an organization.
A near miss may also be called a close call, near collision or near hit.
Near miss events should be investigated, recorded and the experiences shared to lessen the chances of similar occurrences. Most accidents are preceded by similar near misses that should act as warnings. As such, reporting of near misses is an established way of reducing risk in many organizations.
Incident: an unintended event that disturbs normal operations.
OSHA defines an incident as "an unplanned, undesired event that adversely affects completion of a task."
Incidents range in severity from near misses to fatal accidents. Simply put, all near misses are incidents but not all incidents are near misses.
