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Reporting an Unusual Occurrence to a Patient

Whenever a student, during his/her clinical experience in a hospital or public health agency, is involved in an unusual occurrence concerning a patient, these steps must be followed once the immediate needs of the situation have been met:

  1. The policy of the agency for reporting an incident will be followed. Send one copy of the agency's incident report to:

      University of Washington
      Risk Management Office
      Box 351276
  2. The student and instructor/preceptor will complete UW Form 60266, available in the School of Nursing Academic Services (T310). Once completed, the pink copy remains with the student. Send the two remaining copies of the report to:

      University of Washington
      Risk Management Office
      Box 351276

    You may wish to photocopy the completed form and send it to the Director of Academic Services at Box 357260.
  3. The Director of Academic Services should be notified by phone (206-543-8736) within 24 hours that an incident has occurred.

If a student is injured or becomes ill at a clinical site, follow AS Memorandum 22.

Revised April 2010
Academic Services Memo No. 14