Free Incident Report for Medical Treatment Template
Incident Report for Medical Treatment
I. Incident Details
On May 30, 2054, at 10:00 AM, a medication error occurred in [YOUR COMPANY NAME], Ward 3A. Nurse Velma Massey administered Paracetamol 500mg orally to a patient, despite the medication not being prescribed for this patient.
II. Description of Incident
The error was identified when Nurse Jacob Howard witnessed the administration and noticed the discrepancy. The patient was scheduled to receive Ibuprofen 400mg, not Paracetamol. Immediate steps were taken to mitigate any potential harm.
III. Individuals Involved
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Velma Massey: Registered Nurse responsible for administering medications.
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Jacob Howard: Registered Nurse who witnessed the incident and reported it.
IV. Witness Statement
Jacob Howard: "I witnessed Nurse Velma Massey administer the medication to the patient. Upon checking the patient’s chart, I realized the error and reported it immediately."
V. Actions Taken
|
Immediate Actions Taken |
Follow-Up Actions |
|---|---|
|
Notified senior nurse and physician |
Reviewed medication administration protocol with staff |
|
Monitored patient closely |
Implemented additional training sessions for nurses |
VI. Outcome
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Patient Outcome:
The patient experienced no adverse effects from the error. Vital signs were monitored every 30 minutes for four hours post-administration, and no abnormalities were detected.
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Healthcare Worker Outcome:
Nurse Velma Massey received further training to reinforce the importance of verifying medication orders before administration. The hospital also decided to implement periodic competency checks for all nursing staff.
VII. Signature
[YOUR NAME], MD
[YOUR COMPANY NAME]
May 30, 2054
