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Please make sure you have an APA title page and 3 references within the last 5 years ( references must be in text and on the reference page).
Patient fall incident report form example
Date: [Date]
Time: [Time]
Location: [Ward/Room Number]
Patient Name: [Patient’s Full Name]
Medical Record Number: [Patient’s MRN]
Description of Incident: Patient [Patient’s Name] fell in their room while attempting to get out of bed. The incident occurred at approximately [Time]. The patient sustained [Describe Any Injuries].
Actions Taken:
[Nurse’s Name] responded immediately, assessed the patient, and called for assistance.
The patient was transferred to [Location] for further evaluation and treatment.
Physician notified.
A fall risk assessment is to be conducted, and appropriate interventions to prevent future falls are to be implemented.
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