Central Placement Office (School of Nursing)

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Practice Injury/Incident Reporting

Students that are actively enrolled and participating in clinical practice are eligible for Workplace Safety and Insurance Board (WSIB) coverage in the event of an injury/incident while attending a coordinated school experience. Students attending a self-coordinated volunteer experience are not eligible.

In the event of an injury/incident while attending practice placement students must:

  • follow placement agency/facility protocol in seeking personal medical attention and reporting,
  • notify their practice instructor/faculty advisor the day of the injury/incident, and
  • submit the required reporting documentation.

WSIB reporting is required if the injury/incident may result or has resulted in any of the following:

  • Health care by a medical practitioner for which there is a fee for service (i.e. physician, chiropractor, dentist, hospital and/or health facility(ies)

and/or

  • Loss of time from work, placement and/or university beyond the date of the incident

and/or

  • Exposure to and/or contraction of a communicable disease (i.e. TB exposure, needlestick)

If the practice incident is an accident/injury, please follow placement agency/facility protocol for reporting and obtaining personal medical attention. Please note: if additional medical attention is desired, students are encouraged to seek attention from their family practitioners or the Ryerson University, Health Centre, KHW-181. Obtain, complete and submit the following WSIB documentation (completed by student):

* Ryerson Contact Person (Practice Year Lead Faculty):
Collaborative Year 1 – Daria Romaniuk ext. 6310
Collaborative Year 2 – Vaska Micevski ext. 4842
Collaborative Year 3 – Corinne Hart ext. 6305
Collaborative Year 4 – Jasna Schwind ext. 6321
Post-diploma – Sharon Wilson ext. 6327
Master – Heather Beanlands ext. 7972

* * Form 7: (e-Form 7 is not an option for submission. Student and contact person (instructor/faculty advisor) signatures are required on page 3)

* * Form 7:
Worker Information (Section A):
Job Title – Nursing Student

Employer Information (Section B):
Trade & Legal Name- Ministry of Training, Colleges & Universities
Firm # - 825010
Mailing Address – 900 Bay St., 8th Floor, Mowat Block, Toronto, ON M7A 1L2
Description of Business Activity – Nursing Student – Placement

Official Title (Section J):
Nursing Student

Co-signature required by the contact person (instructor/faculty advisor) at the bottom of page 3.

If the practice incident is a needlestick or body fluid splash, please follow placement agency/facility protocol for reporting and obtaining personal medical attention. Please note: if additional medical attention is desired, students are encouraged to seek attention from their family practitioners or the Ryerson University, Health Centre, KHW-181. Obtain, complete and submit the following WSIB documentation:

* Ryerson Contact Person (Practice Year Lead Faculty):
Collaborative Year 1 – Daria Romaniuk ext. 6310
Collaborative Year 2 – Vaska Micevski ext. 4842
Collaborative Year 3 – Corinne Hart ext. 6305
Collaborative Year 4 – Jasna Schwind ext. 6321
Post-diploma – Sharon Wilson ext. 6327
Master – Heather Beanlands ext. 7972

* * Form 7: (e-Form 7 is not an option for submission. Student and contact person (instructor/faculty advisor) signatures are required on page 3)

Worker Information (Section A):
Job Title – Nursing Student

Employer Information (Section B):
Trade & Legal Name- Ministry of Training, Colleges & Universities
Firm # - 825010
Mailing Address – 900 Bay St., 8th Floor, Mowat Block, Toronto, ON M7A 1L2
Description of Business Activity – Nursing Student – Placement

Official Title (Section J):
Nursing Student

Co-signature required by the contact person (instructor/faculty advisor) at the bottom of page 3.

* * * Report on Needlestick Injury or Body Fluid Splash:
Employer Name – Ministry of Training, Colleges & Universities

The above documents are available on the Ryerson University, Daphne Cockwell School of Nursing, Nursing Practice website: http://www.ryerson.ca/cpo/students/ (under Students – Practice Injury/Incident Reporting).

Other documentation may be requested in addition to the above noted forms by WSIB
(i.e. medication prescription, physician notes, ER report, occupational health report). It is advisable to keep copies of any documentation pertaining to the incident.

More detailed information may be obtained on the WSIB website: www.wsib.on.ca 

Steps for Submission of WSIB and Ministry of Training, Colleges, and Universities Paperwork

1. Obtain required forms from CPO website

2. Complete forms.

3. Fax all completed forms to: WSIB (fax: 416.344.4684 or 1.888.313.7373 Attn: Central Processing Unit), and The Ministry of Training, Colleges and Universities (fax: 416.325.1959 Attn: Wendy Parsan).

4. Photocopy all completed forms and retain original forms for personal records.

5. Submit photocopied documents to the appropriate contact for your program in a sealed envelope with the following marking information:

Collaborative Program students:

Attn: Daphne Cockwell School of Nursing, Student Affairs Office, POD 474C
RE: Practice Injury/Incident Reporting Forms - WSIB
Student: (print first and last name)
Ryerson Student #:
Confidential – For Student’s File

Post Diploma Degree Program students:

Attn: Daphne Cockwell School of Nursing, Post Diploma Program Secretary, POD 476B
RE: Practice Injury/Incident Reporting Forms - WSIB
Student: (print first and last name)
Ryerson Student #:
Confidential – For Student’s File

Masters Program students:

Attn: Daphne Cockwell School of Nursing, Graduate Program Administrator, POD 482C
RE: Practice Injury/Incident Reporting Forms - WSIB
Student: (print first and last name)
Ryerson Student #:
Confidential – For Student’s File

Forms may be submitted to the appropriate contact for your program directly during office hours or in the after hours POD 481 (Nursing General Office) drop-slot.

Submission of documents to WSIB, Ministry of Training, Colleges and Universities, and Student Affairs must be done within three (3) days of the incident

In the event of a practice injury/incident requiring first aid treatment only, please follow placement agency/facility protocol for reporting and obtaining personal medical attention. WSIB reporting is not required.  Please note: if additional medical attention is desired, students are encouraged to seek attention from their family practitioners or the Ryerson University, Health Centre, KHW-181. If additional medical attention occurs or you are uncertain about the potential severity of the incident, please obtain, complete and submit the WSIB documentation, as instructed above.

First aid is defined by WSIB (n.d) as the following: a “one-time treatment or care and any follow-up visit(s) for observation purposes only. First aid includes, but is not limited to:

  • cleaning minor cuts, scrapes, or scratches treating a minor burn applying bandages and/or dressings applying a cold compress, cold pack, or ice bag applying a splint changing a bandage or a dressing after a follow-up observation visit”.

Steps for Submission of First-Aid Paperwork

  • Photocopy any documentation reflective of the first aid incident (i.e. occupational health department report) and retain original copy for personal records.
  •     Submit photocopied documents to the appropriate contact for your program in a sealed envelope with the following marking information:

Collaborative Program students:

Attn: Daphne Cockwell School of Nursing, Student Affairs Office, POD 474C
RE: Practice Injury/Incident Reporting Forms - WSIB
Student: (print first and last name)
Ryerson Student #:
Confidential – For Student’s File

Post Diploma Degree Program students:

Attn: Daphne Cockwell School of Nursing, Post Diploma Program Secretary, POD 476B
RE: Practice Injury/Incident Reporting Forms - WSIB
Student: (print first and last name)
Ryerson Student #:
Confidential – For Student’s File

Masters Program students:

Attn: Daphne Cockwell School of Nursing, Graduate Program Administrator, POD 482C
RE: Practice Injury/Incident Reporting Forms - WSIB
Student: (print first and last name)
Ryerson Student #:
Confidential – For Student’s File

Forms may be submitted to the appropriate contact for your program directly during office hours or in the after hours POD 481 (Nursing General Office) drop-slot.

Submission of documents to Student Affairs must be done within three (3) days of the incident

 

Reference
Workplace Safety and Insurance Board of Ontario. (n.d). How do I report an injury or illness to the WSIB? Retrieved July 18, 2008, from http://www.wsib.on.ca/wsib/wsibsite.nsf/Public/EmployersIIhowtoreport

 

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