Get Unusual Incident Report

Filing an Unusual Incident Report is an essential step in documenting and addressing unusual occurrences within a facility. This guide will walk you through the process of filling out the report online, ensuring that you complete each section accurately and comprehensively.

Follow the steps to complete the Unusual Incident Report effectively.

1. Press the ‘Get Form’ button to access the report and launch it in the online editor.
2. Begin by entering the month and year of the incident. This information is crucial for timely documentation.
3. Fill in the ‘Provider/Facility Name’ field with the relevant facility's name. Ensure that this name matches the organization responsible for the incident.
4. Document the UI #, Date, and Time of the incident accurately. This provides a precise timeline for events.
5. In the ‘Injury’ section, briefly describe any injuries that occurred during the incident.
6. Complete the ‘Home Name and Address’ field with the name and address of the location where the incident took place.
7. Specify the location within the facility where the incident happened. This detail can aid in understanding the context.
8. Indicate the county where the incident occurred. This may be necessary for local record-keeping.
9. In the ‘Description of the Incident’ section, provide a comprehensive overview of what transpired, including any immediate actions taken to ensure the health and safety of those involved.
10. Identify any causes and contributing factors that may have led to the incident. This analysis helps in preventing similar occurrences in the future.
11. Outline a prevention plan that addresses how similar incidents will be avoided in the future.
12. Review the options regarding trends and patterns identified and addressed, marking ‘YES’ or ‘NO’ as applicable.
13. If trends and patterns are identified, detail the actions taken to address these issues in the designated section.
14. Finally, review your entries for accuracy. Once satisfied, you can save the changes, download, print, or share the completed form.

Complete your Unusual Incident Report online today to ensure clarity and compliance in your documentation.