Injury and Incident Reporting

Faculty of Nursing undergraduate students are required to report occasions of injury and other incidents. Routine incident reporting is required for situations of student injury ("workplace injury") or a patient safety incident. Critical incident reporting is required in addition to routine incident reporting in situations of serious risk or harm to a client/patient, student or faculty member.

Directions and forms for reporting are listed below.

Routine Incident Reporting

A) Workplace Injury

If you are injured or are exposed to human blood/body fluids during your clinical practicum let your clinical instructor know immediately. Your instructor will ensure that you receive first-aid treatment immediately and make the charge nurse aware of the incident. You will follow the protocol of the agency in which you are injured.

As a University of Alberta student, you are required to fill out the University of Alberta Incident Report and the University of Alberta "Workers' Report of Injury or Occupational Disease" form for the Workers' Compensation Board-Alberta (WCB). Your instructor has copy of the WCB forms. The WCB form is time sensitive and must be submitted with 24 hours of the injury occurring.

If you cannot complete all of the information, for example you are not sure of your social insurance number or health care number, send in the document with the information missing. This information can be added later.

The forms need to be returned to the Faculty of Nursing.

Please fax completed form to (780) 492-2551 or email the form to, attention to:

  1. Denise Pasieka - NURS 221, SCI INF 221, NURS 225/345, NURS 321/431, NURS 325/435, NURS 485, NURS 498 (IEN), Adult NP, and Neonatal NP.
  2. Kerry Rusk - NURS 323/433, NURS 327/437, SCI INF 327, NURS 425, and Family All Ages NP. Please fax completed forms to: Denise Pasieka, Clinical Placement Coordinator, (780) 492-2551.

If you send by fax, ensure that you verify that the forms have been received by sending an email to

B) Patient Safety Incident

You are required to complete the incident report form used by the clinical agency where the patient is situated.

Critical Incident Reporting and COVID-19 Reporting

In situations of serious risk or harm to a client/patient, student or faculty member, and in situations of exposure to COVID-19 and/or if experiencing COVID-19 symptoms you are required to fill out the Faculty of Nursing Critical Incident Report (Google Form).