Follow the steps to successfully fill out the MN FSI - Fall Scene Investigation Report online.

1. Press the ‘Get Form’ button to access the form and open it in your editing platform.
2. Begin by entering the facility name at the top of the form. This information identifies the location where the incident occurred.
3. Fill in the resident's name, medical record number, and room number in the corresponding fields. This ensures that the report is linked to the correct individual.
4. Record the date and time of the fall, specifying AM or PM. Accuracy in this detail is essential for creating a reliable timeline.
5. Input the admission date to provide context for the resident’s history.
6. Identify any staff or witnesses present at the time of the incident by listing their names in the provided space.
7. In Section 1, check all observed factors that might have contributed to the fall, selecting options such as loss of balance or slip, and provide detailed descriptions as necessary.
8. For the fall description, ensure that a clear drawing or written description of the scene is included, detailing the position of the resident and any surrounding furniture or equipment.
9. In Section 3, summarize the fall type, indicating whether it was witnessed, unwitnessed, or self-reported.
10. Under Fall Location, select the appropriate area where the fall occurred, such as resident room or bathroom, ensuring to provide details about the specific environment.
11. Record what the resident was doing prior to the fall, choosing relevant options from the list provided.
12. Indicate the type of assistance the resident was receiving at the time of the fall, selecting from the options given.
13. Capture the resident’s statements regarding their actions before the fall in the designated space.
14. Describe the resident's mental and psychological status prior to the fall, comparing it with their usual state.
15. Indicate the type of footwear the resident was wearing and answer questions regarding their sensory capabilities that may have contributed to the fall.
16. Document information on alarms in use at the time of the fall and their functionality.
17. Complete the vital signs section, checking for any abnormalities and documenting orthostatic blood pressure results.
18. Ensure you note any significant findings regarding blood sugar levels for diabetic residents.
19. In the re-creation section, provide a narrative that summarizes the last three hours leading up to the fall, along with notes from the Falls Team Meeting.
20. Finally, describe the root cause of the fall and outline the initial interventions needed to prevent future incidents. Ensure to update any relevant care plans and nurse aide assignments before submitting.
21. Once all sections are complete, you can save your changes. Options to download, print, or share the completed form will be available.

Complete the MN FSI - Fall Scene Investigation Report online to ensure accurate documentation and support safety measures.