NASA Procedures and Guidelines

This Document is Obsolete and Is No Longer Used.
Check the NODIS Library to access the current version:
http://nodis3.gsfc.nasa.gov

NPR 8621.1

Eff. Date: June 02, 2000

Cancellation Date: February 11, 2004

NASA Procedures and Guidelines for Mishap Reporting, Investigating, and Recordkeeping

Appendix K. Incident Reporting Information System (IRIS)
When a safety incident occurs, any of a number of people and organizations may have initial information about the case. One objective of IRIS is to make it as easy as possible for individuals to submit information to the safety office as soon as possible.

Each Center should assign and train a person(s) in each of their local organizations on how to use IRIS (including someone at the clinic or medical unit). This representative will have limited access to the system and be responsible for their organization's safety data and control data. The e-mail address of these representatives will be posted in the system so that the system can notify them of cases for which they must provide more information as a result of being the responsible organization.

Submitting an initial report using the 1627 Online Forms

There are three new online 1627 forms. These forms were designed to be friendlier to the person submitting the report.

Initial Safety Incident Report (Form 1627A) -- This is similar to the current Telephonic Mishap Report form. It is used to collect a lot of narrative information (what, when, where, and how bad, but not who).
Medical Safety Incident Report (Form 1627B) -- This is a newly developed form to collect safety-related information about the injured/ill person from an individual who knows the details about the injured/ill person (i.e., the clinic or the person's supervisor).
Mishap Report (Form 1627) -- This is the full reporting form. It contains everything on the 1627A and 1627B forms along with other information, which is generally not readily available within a few hours of the incident.

These forms are to be used by individuals who have access to a computer that has MS Word but does not have access to IRIS. As a set, these forms can easily be worked into a Center's current business process. Each Center can choose to use one, two, or all three of the forms depending on how they work best for that Center.

The organization's safety representative can enter the data into IRIS and electronically submit the data to the local safety office. The local safety office will be notified electronically about the new case after it is entered. Additionally, the forms can be sent to the local safety office for entry if your procedures prevent others from entering the data. Hard copy forms may be obtained from the Center's safety office.

Submitting initial reports using hand/typewritten 1627 forms

The hand/typewritten forms are primarily for individuals who report incidents but do not have access to IRIS or MS Word. The 1627 forms can be filled-in by hand or typewriter. The online forms can be printed from any computer and copied so that blank copies are available. After manually completing the form, it can be sent to the organization's safety representative or to the local safety office for entry.

Submitting initial reports using the IRIS Screens

IRIS provides three screens for entering initial safety incident cases:

Initial Safety Incident Report (Form 1627A) Screen
Initial Medical Safety Incident Report (Form 1627B) Screen
Full Safety Incident Report (Form 1627) Screen

These screens are the "heart" of the system and the most efficient means of capturing accurate new/updated case information.

These screens correspond to the online and printed 1627 forms. The first two screens (1627A and 1627B) are intended for use by persons outside your local safety office. When the user presses the "Submitted to Safety" button, the record becomes "certified," the safety office is notified, and the record is locked from being changed from either of these screens. The user can view the record but cannot change it.

The Full Safety Incident Report (Form 1627) screen has several additional features for use by safety personnel:

Allows updating and dropping of cases,
Allows addition of corrective action,
Allows case statusing and assignment of case category,
Allows addition of multiple persons injured in a single case,
Allows addition of cause, contributing cause, objects/substance involved, and activity/unsafe act in progress,
Allows addition of property damage data (estimated and final costs, etc.),
Allows assignment of primary NASA investigator/monitor, and
Allows closing the case.

Complete setup and operation of the IRIS system can be found in the IRIS Operating Manual. The NASA Center safety office has access to the IRIS system and can provide a copy of the manual to interested parties. The IRIS system is restricted to authorized users and is password protected. The following directions and computer screens are directly from the IRIS Operating Manual.

1627A FORM

The 1627A form is intended for use by non-safety personnel who can provide initial information about a safety related incident.

1627A Page 1
This page contains general information about the incident.

The following fields appear at the top of all pages:

Field	Description
Year	Auto-filled with the Fiscal Year of the incident based on the Incident Date entered.
Case	Auto-filled with the next highest Case Number for the Site and Fiscal Year combination after the submitter presses the "Submit To Safety" button.
Site	Auto-filled with the Site Code based on the General Location that is entered.
Category	Auto-filled with "To Be Determined" when the case is a new case. After the case is classified, this field will contain one of several types of Case Category: A B C Incident Mission Failure First Aid Only Close Call
Status	Auto-filled with "Initial Report" when the case is a new case. After the case is classified, this field will contain one of several types of Case Status: Open Closed Dropped

The following fields and buttons display at the bottom of every page:

Field/Button	Description
Submitted By	Auto-filled with the User Name of the person who originally entered the case. This information comes from the list of users maintained on the User Administration screen.
Organization	Auto-filled with the Organization Code of the person who originally entered the case. This information comes from the list of users maintained on the User Administration screen.
Mail Code	Auto-filled with the Mail Code of the person who originally entered the case. This information comes from the list of users maintained on the User Administration screen.
Phone	Auto-filled with the Phone Number of the person who originally entered the case. This information comes from the list of users maintained on the User Administration screen.
Date	Auto-filled with the current date after the submitter presses the "Submit To Safety" button.
Time	Auto-filled with the current time (in 24-hour clock format) after the submitter presses the "Submit To Safety" button.
Page 1 Button	Moves to Page 1 of this screen.
Page 2 Button	Moves to Page 2 of this screen.
Page 3 Button	Moves to Page 3 of this screen.
Find Button	Opens the "Find Cases" window from which the user can enter special search criteria to locate cases.
Print Button	Displays a "Print Report" dialog box from which the user can choose to Close, Print to printer or Print Preview on screen the 1627A report for the currently displayed case.
New Button	Moves to an empty record into which the user can enter a New case.
Submit To Safety Button	Validates the newly entered case, assigns a Case Number, saves the record, prevents modification of the record from this screen, and sends an e-mail message to the local Safety Office informing them of the new case. Validation includes ensuring that all required fields contain data, and at least one Impact Summary item is selected.
Close Button	Closes the 1627A screen (if the current record is valid).

The following fields appear only on Page 1 of the 1627A Screen and the user moves through the page in the following tab order:

Field	Description
Date of Incident	This field will accept valid dates entered in many different formats; however, after entry, the field will display the date in MM/DD/YYYY format. After this date is entered, the Fiscal Year field will be adjusted to match the fiscal year for this date.
Time of Incident	This field will accept valid times entered in many different formats; however, after entry, the field will display the time in HH:MM format. To enter "7:30 PM" type "7:30 PM" or "19:30". The colon is required for the field to accept the date.
General Location	This field contains a limited list of values from which the user must choose one. The list is maintained from the General Locations Maintenance screen found under the Safety Menu. This field usually contains large, well-known areas of a site (e.g., area name/number, building, facility, etc.) After selecting a General Location, the corresponding Site Code is automatically entered into the Site field at the top of the screen.
Exact Location	The Exact Location is any other descriptive information the user can provide which also relates to the General Location (e.g., room number, floor, street, etc.)
Responsible Organization	The civil service or contractor organization that is most responsible for the occurrence of the incident. This field contains a limited list of values from which the user must choose one. If currently unknown, enter "TBD" (to be determined) as the organization. After entering the Responsible Organization, the Contract Number, Organization POC, Mail Code, and Phone fields, will be auto-filled with the corresponding information entered in the Organization Codes Maintenance Screen (under the Safety Menu). The user can manually override these defaults by enter the correct value in the appropriate field.
Org. File Number	The file number that the Responsible Organization assigned to the case. This field is not required. Centers can choose to use this field in any manner they wish.
Organization Point of Contact	Auto-filled with the POC name for the Responsible Organization after the Responsible Organization is entered. The user can override the auto-entry with any other value.
Mail Code	Auto-filled with the Mail Code for the Responsible Organization's POC after the Responsible Organization is entered. The user can override the auto-entry with any other value.
Phone	Auto-filled with the Phone Number for the Responsible Organization's POC after the Responsible Organization is entered. The user can override the auto-entry with any other value.
Mission Affected	The name, number or other signifying value that identifies the mission, program, or project affected by this incident. This field is not required but is recommend if known.
Program Impact	The impact to the mission, program or project in terms of schedule delays, cost adjustments, etc. This field is not required but is recommend if known.

Find Cases Screen

The Find Cases Screen is available from the Full 1627, 1627A, and 1627B input screens. This screen opens automatically when the full 1627 screen is opened. The user can manually open this screen from any of the 1627 screens by pressing the screen's Find Button.

To use this screen, enter data into one or more of the Search Elements. After entering the data, press the Find Cases button. If any cases exist that match the search criteria, the matches will be displayed under Cases Found. One or more cases may match the search criteria. The View Cases button will load all of the matching cases into the 1627 screen that originally opened the Find Cases Screen. The View Cases button will also perform the functions of finding matching cases and loading matching cases to the 1627 screen.

Note: Only the cases for sites and organizations that are available to the current user will be found.

1627A Page 2

This page contains the narrative description about the incident.

Field

Description

Incident Description

This is a required field. Use this field to enter as much narrative detail as necessary to fully describe the incident. If known, include in the description the extent of damage and/or injury/illness, conditions that led to the incident, the cause, objects/substances involved, unsafe acts in progress, etc. Note: do not use in this field actual names of injured/ill persons or persons alleged to have caused the incident.

1627A Page 3

This page contains the incident impact summary.

Check one or more of the following Impact Summary check boxes by clicking in the box with the mouse. At least one of the Impact Summary items must be selected for a new record to be valid.

The following table describes the general usage of the items.

Note: NPD 8621.1, "NASA Mishap Reporting and Investigating Policy," as revised or amended governs the definitions and usage of these items. The descriptions/definitions in NPD 8621.1 will supersede any of the following descriptions/usages in the following table:

As non-safety personnel are not as familiar with proper classification of incidents, many of the Impact Summary items in the following table may be changed/updated by the local safety office after the case is submitted to safety.

Item	Description
Fatality	The case involves one or more fatalities.
Permanent Disability	The case involves one or more persons who were permanently disabled as a direct result of the incident.
3 or more people hospitalized	The case involves 3 or more persons hospitalized for more than observation as a direct result of the incident.
Under 3 people hospitalized	The case involves 1 or 2 persons hospitalized for more than observation as a direct result of the incident.
Loss of Consciousness	The case involves 1 or more persons who loss consciousness as a direct result of the incident.
Injury or Illness	The case involves 1 or more persons who were injured or became ill as a direct result of the incident.
Serious Damage to Aircraft or Space Hardware	Any serious damage to an aircraft or space hardware.
Serious Damage to Flight or Ground Support Hardware	Any serious damage to flight or ground support hardware.
Unexpected Damage Due to Test Failure	Any serious unexpected damage resulting from a failed test.
Damage Estimate Over $1,000,000	Any damage that the submitter believes may result in a repair/replacement cost of over $1,000,000.
Damage Estimate Between $250k and $1M	Any damage that the submitter believes may result in a repair/replacement cost of between $250,000 and $1,000,000 inclusively.
Damage Estimate Between $25k and $250k	Any damage that the submitter believes may result in a repair/replacement cost of between $25,000 and $250,000 inclusively.
Damage Estimate Between $1k and $25k	Any damage that the submitter believes may result in a repair/replacement cost of between $1,000 and $25,000 inclusively.
Damage Estimate Under $1,000	Any damage that the submitter believes may result in a repair/replacement cost of not more than $1,000.
Affected Primary Objective(s) of Mission	Any incident that the submitter believes had a significant negative affect on the primary objective(s) of a NASA mission, program or project.
Significant Program Impact	Any incident that the submitter believes had a significant negative impact in terms of cost, schedule delays, etc. on a NASA mission, program or project.
High-Visibility (internal or external to NASA)	Any incident that the submitter believes will lead to a highly publicized incident internal or external to NASA.
Close Call	Any incident that did not contain any injury/illness, property damage of more than $1,000, or loss of productivity but could have led to one or more of these.

The validation rules for selecting a check box are as follows:

If the user checks the "Close Call" checkbox then only "Damage Estimate Under $1,000" can be checked.
If the user checks the "3 or more people hospitalized" checkbox then "Under 3 people hospitalized" can not be checked (and vise-versa).
Only one of the damage estimate items can be checked.

Multiple items can be checked in all other cases.

1627B FORM

The 1627B form is intended for use by non-safety personnel who can provide initial medical information about the incident and the person involved.

Note: Do not use this form if 2 or more persons are injured or ill in the same case or if not enough information is available about the injured/ill person. Use the 1627A form which does not collect information about the person(s) involved or use the Full 1627 form which is the form that the local safety office uses to gather more detail than the 1627A or 1627B can provide.

1627B Page 1
This page contains the general medical information about the incident.

The following fields appear at the top of all pages:

Field	Description
Year	Auto-filled with the Fiscal Year of the incident based on the Incident Date entered.
Case	Auto-filled with the next highest Case Number for the Site and Fiscal Year combination after the submitter presses the "Submit To Safety" button.
Site	Auto-filled with the Site Code based on the General Location that is entered.
Category	Auto-filled with "To Be Determined" when the case is a new case. After the case is classified, this field will contain one of several types of Case Category: A B C Incident Mission Failure First Aid Only Close Call
Status	Auto-filled with "Initial Report" when the case is a new case. After the case is classified, this field will contain one of several types of Case Status: Open Closed Dropped

The following fields and buttons display at the bottom of every page:

Field/Button	Description
Submitted By	Auto-filled with the User Name of the person who originally entered the case. This information comes from the list of users maintained on the User Administration screen.
Organization	Auto-filled with the Organization Code of the person who originally entered the case. This information comes from the list of users maintained on the User Administration screen.
Mail Code	Auto-filled with the Mail Code of the person who originally entered the case. This information comes from the list of users maintained on the User Administration screen.
Phone	Auto-filled with the Phone Number of the person who originally entered the case. This information comes from the list of users maintained on the User Administration screen.
Date	Auto-filled with the current date after the submitter presses the "Submit To Safety" button.
Time	Auto-filled with the current time (in 24-hour clock format) after the submitter presses the "Submit To Safety" button.
Page 1 Button	Moves to Page 1 of this screen.
Page 2 Button	Moves to Page 2 of this screen.
Page 3 Button	Moves to Page 3 of this screen.
Page 4 Button	Moves to Page 4 of this screen.
Page 5 Button	Moves to Page 5 of this screen.
Find Button	Opens the "Find Cases" window from which the user can enter special search criteria to locate cases.
Print Button	Displays a "Print Report" dialog box from which the user can choose to Close, Print to printer or Print Preview on screen the 1627B report for the currently displayed case.
New Button	Moves to an empty record into which the user can enter a New case.
Submit To Safety Button	Validates the newly entered case, assigns a Case Number, saves the record, prevents modification of the record from this screen, and sends an e-mail message to Safety informing them of the new case. Validation includes ensuring that all required fields contain data, and at least one Injury/Illness Summary item is selected.
Close Button	Closes the 1627B screen (if the current record is valid).

The following fields appear only on Page 1 of the 1627B Screen and the user moves through the page in the following tab order:

Field	Description
Date of Incident	This field will accept valid dates entered in many different formats; however, after entry, the field will display the date in MM/DD/YYYY format. After this date is entered, the Fiscal Year field will be adjusted to match the fiscal year for this date.
Time of Incident	This field will accept valid times entered in many different formats; however, after entry, the field will display the time in HH:MM format. To enter "7:30 PM" type "7:30 PM" or "19:30." The colon is required for the field to accept the date.
General Location	This field contains a limited list of values from which the user must choose one. The list is maintained from the General Locations Maintenance screen found under the Safety Menu. This field usually contains large, well-known areas of a site (e.g., area number, building, facility, etc.). After selecting a General Location, the corresponding Site Code is automatically entered into the Site field at the top of the screen.
Exact Location	The Exact Location is any other descriptive information the user can provide which also relates to the General Location (e.g., room name/number, floor, street, etc.).
Incident Description or Symptoms of Injured/Ill Person	This is a required field. Use this field to enter as much narrative detail as necessary to fully describe the incident, injury, illness or symptoms thereof. If known, include in the description the extent of damage and/or injury/illness, conditions that led to the incident, cause, objects/substances involved, unsafe acts in progress, etc. Note: do not use in this field the actual names of injured/ill persons or persons alleged to have caused the incident.

1627B Page 2

NASA Procedures and Guidelines

This Document is Obsolete and Is No Longer Used. Check the NODIS Library to access the current version: http://nodis3.gsfc.nasa.gov

NASA Procedures and Guidelines for Mishap Reporting, Investigating, and Recordkeeping

DISTRIBUTION: NODIS

This Document is Obsolete and Is No Longer Used. Check the NODIS Library to access the current version: http://nodis3.gsfc.nasa.gov

This Document is Obsolete and Is No Longer Used.
Check the NODIS Library to access the current version:
http://nodis3.gsfc.nasa.gov

DISTRIBUTION:
NODIS

This Document is Obsolete and Is No Longer Used.
Check the NODIS Library to access the current version:
http://nodis3.gsfc.nasa.gov