The Patient Safety Incident Reporting Form is a crucial document required by Singapore's healthcare regulatory framework. It serves as an essential tool for healthcare providers to document, track, and analyze patient safety incidents, enabling systematic improvement of healthcare delivery. The form aligns with Singapore Ministry of Health guidelines and the Healthcare Services Act 2020, requiring detailed documentation of incidents, immediate actions taken, and contributing factors. This standardized reporting mechanism helps healthcare organizations maintain compliance, identify trends, and implement preventive measures to enhance patient safety.
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1. Incident Details: Date, time, location, and type of incident
2. Patient Information: Basic patient demographics and medical record number
3. Incident Description: Detailed narrative of the incident including what happened, how it happened, and immediate impact
4. Immediate Actions Taken: Steps taken to address the incident and mitigate any harm
5. Staff Involved: Details of healthcare workers involved in or witnessing the incident
1. Witness Statements: Additional observations from witnesses when present during the incident
2. Equipment Details: Information about medical equipment involved in cases of equipment malfunction or misuse
3. Next of Kin Notification: Details of family notification in cases of serious incidents
1. Incident Classification Guide: Reference guide for categorizing incidents according to MOH guidelines
2. Risk Assessment Matrix: Tool for evaluating incident severity and likelihood
3. Investigation Checklist: Standardized checklist for incident investigation procedures
4. Supporting Documentation Template: Template for attaching photos, diagrams, or additional relevant documents
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