Activity 32: Incident reporting

Conduct a workplace incident report.

You are required to execute the form in its entirety according to workplace procedures and legislative requirements, based on incident that has occurred at the organisation.

Incident Report:

Date: 23rd November 2023

Time: 7:45 AM

Location: SIL Tenterden

Description of Incident:

On the 23^rd of November 2023, at approximately 07:45 am, while working at SIL Tenterden, a customer, 'x', was involved in an incident. The customer became agitated during mealtime and started exhibiting aggressive behaviour towards other residents.

Description of Injuries or Damage:

During the incident, one resident (customer 'y'), sustained minor scratches on the arm due to the customer's behaviour. No significant damage to property was reported.

Witnesses:

Co-worker named Tom was present.

Contributing Factor:

The customer's agitation appeared to be triggered by a change in routine and loud noises in the dining area.

Actions Taken:

Staff intervened immediately to ensure the safety of all residents. The customer was calmly redirected to a quieter area with the assistance of staff members. First aid was administered to the resident who sustained scratches, and their guardian was notified of the incident.

Follow-up Actions:

Action	Status
Conduct debriefing session with staff members involved	Completed
Document incident in facility records for review	In Progress
Implement additional support and monitoring for the customer	Planned

Incident report form (for use in Activity 32 as required)

Incident report form
Section A - Execute for all incidents
Site/ Program	SIL Tenterden	If other (please specify)
Client name	'x'
Date of incident	23rd November 2023	Time	07:45 AM
Person completing	Derrick Holmes
Name of person affected	'y'	Client Staff Other
Names of others involved	Co-worker Tom
Was there an injury/ potential injury to (complete Section B)?	Client Staff Other
Was there an illness (complete Section B)?	Client Staff Other
Was there a behaviour?	Yes No
Details of the Incident (use first initial of first name and full last name)
What happened before the incident (including contributing factors and triggers)?	I, Derrick Holmes, had been informed that customer 'x' would not be attending their day program as their 1:1 support called in sick and there was no one to replace them. I then informed customer 'x' about the change. The customer then became agitated during mealtime with the change in their routine as well as the loud noises in the dining area.
What happened during the incident?	The customer exhibited aggressive behaviour towards other residents, resulting in one resident sustaining minor scratches.
What happened after the incident (including actions taken)?	Staff members intervened immediately, providing first aid to the injured resident and calming the customer down. The incident was documented, and a debriefing session was conducted with staff members involved.
Is there a need for critical debriefing?	Yes No
If yes, please indicate debriefing type required.	Critical Incident debriefing Discussions with supervisor Additional support
Was restrictive practice used?	Yes No
Do you have any suggestions how this type of incident can be prevented in the future? If yes, please specify.	Implementing strategies to minimize disruptions during mealtime, such as maintaining a calm environment and ensuring consistent routines.
Signature of person completing	Derrick Holmes
Section B -Injury/ illness (only complete for injury/ illness to staff or client)
Type of injury	Electric shock Bite/ sting Skin puncture/ cut Facture/ dislocation Grazes/ abrasions Contact with no bruising injury Repetitive strain Amputation Bruising/ crushing Concussion Burns/ scalds Loss of consciousness Sprain/ strain Multiple injuries Poisoning Psychological Other (please specify)
Type of illness	Infection (bacterial) Infection (viral) Vomiting/ diarrhoea Other (please specify)
Complete for staff injury only	At work During overtime On way to/ from work Other (please specify)
Did the person return to work?	Yes No
Did the person?	Stay on site Go home
Was medical treatment provided?	Yes No
If yes, please indicate type of treatment provided.	Hospital (specify name of hospital) First aid Visited doctor
Has the Return-to-Work (RTW) Coordinator been notified?	Yes No
Section C - Team Leader/ Manager comments (usually by Team Leader)
Date form received
Person completing		Position
Names of others consulted
Type of incident	Client behaviour resulting in potential/ actual injury to another client (if physical contact was made, ensure Section B completed) Client behaviour resulting in potential/ actual injury to staff if physical contact was made, ensure Section B completed and forward copy to RTW Coordinator) Client behaviour resulting in medication not being taken Medication (complete medication error report) Client illness (ensure Section B is completed) Staff illness (ensure Section B is completed) Other (please specify)
Does the client have a BIS Plan?	Yes (review plan) No (review need for a plan)
Recommendations and follow up including review of plans and risk profiles (include details of who will complete and by when)	Conduct a review of the BIS Plan and implement additional support strategies.
Strategies put in place to prevent this type of incident in the future
Risk management required?	Yes No
If injury - Register of injuries completed	Yes No
If injury - incident report sent to RTW Coordinator	Yes No
If medication - medication error report completed	Yes No
Relevant Civic Divisions/ Organisation's/ Services advised of incident	Yes No
Client Risk Profile updated	Yes No
Incident debriefing provided	Yes No
Date
Signature of the person completing
Section D - Incident Acknowledgement (usually by Senior Manager for site program)
Date form received
Person completing		Position
Name of others consulted
Recommendations and follow up including review of plans and risk profiles (include details of who will complete and by when)
All actions completed	Yes No (If no, advise when incident will be closed). Date:
Date incident closed off
Signature of the person completing
Section E - Incident review (usually by Specialist Support Team, HR or Quality Team)
Date form received
Person completing		Position
Comments	-
Improvement to process required	Yes (complete Improvement Request) No
Signature of the person completing

Activity 35: Facilitate a debriefing session

Part A

During the Skills Assessment Visit, and with your Trainer and Assessor, you will be asked to conduct a structured post-incident debriefing sessionbased on the same incident from Activity 32.

You will need to prepare for the session.

To prepare:

• access and read the organization's policies and procedures related to emergency and critical incidents
• determine the type of debriefing required (making sure the type you select aligns with the organization's policies and procedures, the scope of a community service worker's role, and your skillset)
• Put into words an agenda (this should show a clear outline of what will happen in the meeting and a clear sequencing of the planned discussion)
• Put together any other notes that will help you during the debriefing session
• identify and locate any resources that you need (including contact details of where the staff member can get further support and help)
• Put into words an incident overview to provide to your Trainer and Assessor (so that they can effectively play the role of the staff member who witnessed or was involved in the incident)

Part B

In this part, you need to conduct the debriefing session.

To conduct the session you will need access to a safe and private environment.

Before you run the session, you will have the opportunity to provide your Trainer and Assessor with a copy of the incident overview and discuss any other information they need to know to help the session run smoothly.

During the session, your Trainer and Assessor will be looking to see you:

• explain the debriefing process
• use appropriate debriefing and questioning techniques to:
  • review the incident
  • clarify any questions or concerns
  • encourage staff - i.e. the Trainer and Assessor to talk about what happened
  • identify current needs.
• discuss any issues that arise in the session that are relevant to the incident and attempt to find solutions
• share information and advice to help staff - i.e. the Trainer and Assessor to help him/ her to identify and understand the level of risk to his/ her emotional wellbeing and to manage symptoms
• offer information and/or handouts on referrals and support agencies that may be required.

Part C

Use the space below to document the outcomes of the debriefing. For example, note any actions that were agreed on, such as additional support at work through discussions with a staff member who has had a similar experience or has years of service and can offer helpful insights, follow-up support such as counseling or accessing the employee assistance program, dispute resolution, additional training, updating of policies and procedures, etc.