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What to include on the incident report

The incident report for an accident or injury such as a fall should include the following information:

Circumstances of the incident
Date, time, and location of fall, and during which shift and on what unit the fall occurred
Witnesses', staff members', and resident's accounts of the incident
Interventions taken to care for the resident immediately after the incident
Notifications made as a result of an incident
Resident symptoms prior to the incident
Vital signs and observations made after the incident
Resident activity at the time of the incident
Injuries/medical problems associated with the incident
Environmental hazards or faulty equipment contributing to the incident
Presence of any new incident risk factors
Corrective actions taken to reduce the likelihood of another incident