Purpose
Objective
Responsibility
Procedure
Accident Report Form Instructions

Purpose

Accident investigations are necessary to identify accident causation and insure implementation of corrective action. Therefore, supervisors shall immediately investigate and report all occurrences (nearmiss, accidents, illnesses)with a written investigation report.

Objective

Accident investigations help to identify deficiencies in the workplace and implement corrective actions.

Responsibility

It is the responsibility of supervisors to ensure a safe and healthy work environment for their employees. Management must also comply with state policy and government regulations. They must investigate and report all incidents causing injury/illness or property loss immediately with a written investigation report. It is the responsibility of supervisors to complete these reports and transmit them to management and EH&S. Employees are responsible to report all accidents to their supervisor .

Procedure

Supervisors can help improve accident reporting in several ways:

1. Train employees to report all incidents
2. Take action on all incidents immediately
3. Emphasize the importance of reporting incidents in regular meetings with employees.

A successful accident investigation program contains standard investigation techniques or steps. These techniques are:

1. Notification of incident/care for injured person(s)
2. Control hazards/secure accident site
3. Investigate promptly
6. Interview employee and witnesses
7. Implement corrective action
8. Prepare incident form(s)
9. Report the incident to EH&S

EH&S provides supervisor accident investigation training. Call EH&S at 919-515-6871 or for more information.

Accident Report Form Instructions

Answer all questions on the First Report of Injury Form. If no answer is available or the question does not apply, indicate by "D.N.A." (does not apply). Make answers complete and specific.

Use a separate form for each employee injured in a multiple-injury accident. Make sure you enter the anticipated date for implementing corrective action.

Send a copy of the accident investigation report to Environmental Health within 5 days.

When a single accident involves four or more injured persons, or results in the death of a state employee, the supervisor must immediately notify EH&S immediately. Within 8 hours Environmental Health shall notify OSHA, and the Employee Safety and Health Division at the Office of State Personnel.

All Accident reporting forms are available on-line or call the Environmental Health and Safety Center (919-515-6871).