Get the free Near Miss Report Non Illness - University of Memphis - memphis

NearMissReport (Injury/Illness) ThisformshouldbefilledoutfornearmissreportingpurposesONLY. Ifthereisanactualinjury/illness, pleasefillouttheFIRSTREPORT INJURY/ILLNESSFORM.ANearMissisapotentialhazardoranunplannedeventthatdidnotresultinaninjury,

How to fill out near miss report non

How to Fill Out a Near Miss Report Non:

Start by collecting accurate information:

1. Gather details about the near miss incident, such as the date, time, and location.
2. Identify the individuals involved or affected by the near miss.
3. Note any equipment, processes, or procedures involved in the incident.

Describe the near miss incident:

1. Provide a clear and concise description of what happened, including any contributing factors.
2. Use objective language and avoid making assumptions or speculations.
3. Include any observations or actions taken to prevent a potential accident or injury.

Assess the potential consequences:

1. Evaluate the severity of the potential outcome if the near miss had escalated into an actual incident.
2. Consider the potential impact on people, property, the environment, and business operations.

Identify the root causes:

1. Analyze the underlying factors that led to the near miss incident.
2. Look for any unsafe conditions, behaviors, or system failures.
3. Consider both immediate and underlying causes of the near miss.

Provide recommendations for prevention:

1. Suggest specific actions or measures to prevent similar incidents from occurring in the future.
2. Focus on addressing the root causes identified earlier.
3. Include any suggestions for improving equipment, processes, or training.

Who Needs a Near Miss Report Non:

Employees:

1. Workers who directly witnessed or were involved in the near miss incident should report it to their supervisors or safety representatives.
2. It is important for employees to actively participate in near miss reporting to improve workplace safety.

Supervisors and Managers:

1. Supervisors and managers are responsible for ensuring that near miss reports are promptly filed.
2. They play a crucial role in investigating the incident, implementing corrective actions, and preventing future incidents.

Safety Department:

1. The safety department or safety officers are typically involved in overseeing and managing the near miss reporting process.
2. They may analyze the data from near miss reports to identify trends and patterns, and take proactive measures to reduce potential risks.

In conclusion, filling out a near miss report non involves accurately documenting the incident, assessing potential consequences, identifying root causes, and providing recommendations for prevention. The report should be completed by employees who witnessed or were involved in the near miss, and it is important for supervisors, managers, and the safety department to play their respective roles in ensuring workplace safety.

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