Falls and incident reports in LTC - page 3

by Blackcat99

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:uhoh21: Many nurses in LTC tell me that they don't have time to fill out incident reports each time a patient falls. What about you? Do you always fill out an incident report when a patient falls? Thanks... Read More


  1. 0
    I can't imagine NOT filling out an incident report for a fall. No matter how many may occur on a shift. It's your license NOT to mention the resident may have hidden injuries. If you gotta stay longer at work then you gotta stay longer. Been in this situation many times and would never not fill out a report. Finish your meds 1st of course then get busy writing. If you don't have all the details ie: CNA's have already gone home then fill out what you can and explain to your supervisor the next day and finish it then.
  2. 0
    let see falls, bruises ,skin tears something 10 days old that hasn't been documented on yet, post it in the tar, in nurses notes, incident report investigation report, notify Dr. notify family and mini inservice for staff on interventions and statements from anyone who was involved or found areas whew!!!
  3. 0
    I always writ up incidents....minor and major. Don't feel like dealing with the fall out if State walked in and proceeded to walk all over me. That is, if my boss didn't start on me first...."I who should know better...." You get the drift.

    Suebird
  4. 0
    Yes, we have to on my job.
    The requirements on our incident reports are demanding.
    Falls, bruises, skin tears, head injuries, swollen ankles/feet that could possiby be a fracture or any other possible fracture, any kind of injuries around the eyes/face region, anything of UNKNOWN origin must have an incident report filled out. Also, even if we send them to the ED for evaluation of any illness, besides an injury, then it's an incident report also.
    We also do another report called a "Marks Report". This is usually done by the aides who work closely with our people, and they always notify their supervisor that they are filling out a "marks report", so if it COULD be something more injurious/detailed then the nurse gets called in on it to evaluate.
    We do so much documentation and followup reports on my job that we just don't have anything slipping thru the cracks.
    You better fill it out, because tomorrow when the superintendent comes in she's going to ask for that report and it isn't a pleasant thing to have to explain why you didn't do such and such. Better to fill it out and be done with it. CYA.

    My boss says, "If in doubt, fill it out."
  5. 0
    Ok.
    I am the risk manager where I work. It is very important to do the incident reports. We had a resident show up with a fractured hip. I had to do an Adverse Incident with the state. On completion of the investigation, the nurse was terminated because she said she didn't think the resident was injured so she did not do one. This was not the first time she had done this. The resident was demented and could not verbalize pain. 2 shifts later, he developed what the nurse thought was belly pain because he cried when the CNA's got him up. A flat plate was negative. The next shift nurse whipped back the covers and found external rotation and shortening of the leg. Any questions? Always always always do an incident report. If something is found later, you have proof you checked the resident and doccumented for 72 hours. It could save your bacon!
    Do it for all skin tears, bruises, etc.

    Marie
    Last edit by sd90mac on Mar 17, '06
  6. 0
    Quote from sd90mac
    Ok.
    I am the risk manager where I work. It is very important to do the incident reports. We had a resident show up with a fractured hip. I had to do an Adverse Incident with the state. On completion of the investigation, the nurse was terminated because she said she didn't think the resident was injured so she did not do one. This was not the first time she had done this. The resident was demented and could not verbalize pain. 2 shifts later, he developed what the nurse thought was belly pain because he cried when the CNA's got him up. A flat plate was negative. The next shift nurse whipped back the covers and found external rotation and shortening of the leg. Any questions? Always always always do an incident report. If something is found later, you have proof you checked the resident and doccumented for 72 hours. It could save your bacon!
    Do it for all skin tears, bruises, etc.

    Marie
    We had a similar incident in my LTC. In our case there was an investigation by the Illinois State Police months later. Believe me it was not fun. The initial incident occurred where the aides said that the resident was lowered to the floor when she nearly fell during a transfer. It was 3 days later that a spiral fracture was identified and looking back there was no incident report and NO documentation. The nurse on duty at the time said that she did assess the resident but felt that there was no injury. Pain started 2 shifts later but the nurses after knew nothing of the "near fall" and didn't even suspect a fracture. So, it is not only important that we do incident reports for falls but near falls also. What I tell my aides is, "If you were not there to catch them and lower them to the floor, would they have fallen?" They now know that the need to report everything that happens.
    Recently, we had a state survey and they sited us for not fully investigating all falls. They want to see that the nurse at the time of the incident identifies the "CAUSE" of the fall. The report must have all of the details of the investigation including any witness statements attached.
  7. 0
    Yes..always . Unfortunately, ours is a 6 page form even an investigative officer would groan out load about..but it is an absolute necessity to be done.. No matter how long it takes nor how small the incident is. As a busy nurse I just cringe if a CNA comes to tell me about a small skin tear the patient got brushing against a door..or a patient strikes out at someone and so forth..all incidents have to be reported..some immediately to our state within 24 hours, for example a hip fracture
  8. 0
    I can relate. As the risk manager, it is my job to do the investigation. 20 pages later, and statements from all staff involved, we have to determne if it is an adverse incident or not. That's the tricky part. We also have to determine if an employee is at fault or not. That is why all staff is required to check for all safety devices, alarms, etc. and make sure they are in place. I hate to have to talk to a nurse or CNA and question them about what happened. I always tell them to rreport any incident immediatlly and I'll fight for them, but if they don't and try to hide it, I cannot help them. Many are learning I mean what I say. They have stopped complaining about having to write statements and coming in to speak with us. I make sure Human Resources is involved in all discussions for the employees sake and mine. Our incident report is 3 pages, but the initial investigation I do is 3 pages or more. I am teaching the nurses to write everything they can think of, floor wet or dry, shoes on or barefoot, any obstructions, was the safety device on correctly or not on, anything that can help with the investigation. They are beginning to get the message.

    Marie


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