Loading
             
                Get Mn Fsi - Fall Scene Investigation Report
How it works
- 
                    Open form follow the instructions
- 
                    Easily sign the form with your finger
- 
                    Send filled & signed form or save
How to fill out the MN FSI - Fall Scene Investigation Report online
Filling out the MN FSI - Fall Scene Investigation Report is crucial for documenting the circumstances surrounding a fall incident. This guide will provide step-by-step instructions to help users accurately complete the online form and ensure all necessary information is captured.
Follow the steps to successfully fill out the MN FSI - Fall Scene Investigation Report online.
- Press the ‘Get Form’ button to access the form and open it in your editing platform.
- Begin by entering the facility name at the top of the form. This information identifies the location where the incident occurred.
- 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.
- Record the date and time of the fall, specifying AM or PM. Accuracy in this detail is essential for creating a reliable timeline.
- Input the admission date to provide context for the resident’s history.
- Identify any staff or witnesses present at the time of the incident by listing their names in the provided space.
- 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.
- 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.
- In Section 3, summarize the fall type, indicating whether it was witnessed, unwitnessed, or self-reported.
- 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.
- Record what the resident was doing prior to the fall, choosing relevant options from the list provided.
- Indicate the type of assistance the resident was receiving at the time of the fall, selecting from the options given.
- Capture the resident’s statements regarding their actions before the fall in the designated space.
- Describe the resident's mental and psychological status prior to the fall, comparing it with their usual state.
- Indicate the type of footwear the resident was wearing and answer questions regarding their sensory capabilities that may have contributed to the fall.
- Document information on alarms in use at the time of the fall and their functionality.
- Complete the vital signs section, checking for any abnormalities and documenting orthostatic blood pressure results.
- Ensure you note any significant findings regarding blood sugar levels for diabetic residents.
- 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.
- 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.
- 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.
Industry-leading security and compliance
US Legal Forms protects your data by complying with industry-specific security standards.
        - 
                    In businnes since 199725+ years providing professional legal documents.
- 
                    Accredited businessGuarantees that a business meets BBB accreditation standards in the US and Canada.
- 
                    Secured by BraintreeValidated Level 1 PCI DSS compliant payment gateway that accepts most major credit and debit card brands from across the globe.