Follow the steps to successfully fill out the form:

1. Press the ‘Get Form’ button to access the medication safety incident report form and open it in your preferred editor.
2. Fill in the pharmacy details by providing the pharmacy or branch name, branch number if applicable, and the reference number from the LFPSE report.
3. In the incident details section, enter the date and time of the incident, where it occurred, and a detailed description of what happened. Be factual and avoid using opinions.
4. Indicate the degree of harm to the patient from the incident by selecting from the provided options, such as 'near miss' or 'death'.
5. If applicable, describe any actions that minimized the impact of the incident on the patient, and detail any symptoms experienced by the patient after taking or using the medicine or medical device.
6. Enter the main patient's details, including their name, address, telephone number, date of birth, sex, and ethnicity. Also, include information about any known disabilities or impairments.
7. In the contributing factors section, identify what factors may have contributed to the incident, choosing from categories such as communication, education, and medication factors.
8. Specify the stage in the medication process during which the error occurred, selecting from options such as prescribing or administration.
9. Describe the medication incident itself, including any adverse drug reactions or mismatches, and select the appropriate description from the provided options.
10. Identify any other important factors involved in the incident, including communication issues or poor labelling.
11. Provide details of the correct and incorrect medicines or medical devices associated with the incident, including their names, forms, dosages, and manufacturers.
12. List the staff involved in the incident, including names, organisations, and job titles, along with the status of the staff member completing the report.
13. Indicate any required actions, such as whether the patient was referred to another healthcare professional and if the report will be submitted to LFPSE.
14. Once all sections are completed, review the form to ensure accuracy before saving your changes, and then download, print, or share the form as needed.

Start filling out the UK CPE Medication Safety Incident (External) Report Form online today to ensure safety and accountability in medication management.