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How to fill out incident near miss notification

How to fill out an incident near miss notification:

1. Start by clearly identifying the incident or near miss that occurred. Include details such as the date, time, and location of the incident.
2. Describe the incident in detail, providing any relevant information that could help others understand what happened. Include information about any equipment or processes involved, as well as any contributing factors.
3. Provide contact information for yourself or the person reporting the incident. This is important in case there is a need for further investigation or clarification.
4. Make sure to include any actions taken immediately following the incident or near miss. This could include first aid administered, equipment shutdown, or emergency protocols followed.
5. If there were any witnesses to the incident, mention their names and contact information. It may be necessary to gather additional statements or testimonies as part of the investigation.
6. Indicate whether any injuries or property damage resulted from the incident. If there were injuries, provide details about the nature and severity of the injuries.
7. Finally, sign and date the incident near miss notification form to complete the process.

Who needs incident near miss notification?

1. Employers and management: Incident near miss notifications are important for employers and management to ensure that potential hazards are identified and addressed promptly. It allows them to take necessary actions to prevent future incidents and promote a safe working environment.
2. Employees: Employees need incident near miss notifications to report any incidents or near misses they witness or are involved in. This helps create awareness and accountability in the workplace, ensuring that hazards are properly addressed and the risk of future incidents is minimized.
3. Safety committees and regulators: Incident near miss notifications are often required by safety committees and regulatory bodies. These notifications help in monitoring and evaluating safety practices and compliance with regulations. It enables them to identify trends, address any deficiencies, and implement corrective measures to enhance overall workplace safety.

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