POST FALL HUDDLE / AFTER ACTION REVIEW () Nurse Reviewer: Date: Patient Name/ID: Instructions: Hold as soon as possible after the patient fall occurred. Keep the meetings brief; 15 minutes. Involve the patient if possible. Forward completed review to Nurse Manager, then to Patient Safety Manager.(11E) Questions Lessons learned. Why did this patient fall? (Ask 3 times) Was patient at correct fall/injury risk level? Were the appropriate interventions in place? What accounted for the difference? How could the same outcome be avoided the next time? What is the follow up plan? to share) Patient’s account (if able Agreement with the patient for safety (Promise to use call bell; return demo how to use call bell) Type of Fall: ______________________________ Nurse Manager Review: Signature Date_____________________ or information contained herein which resulted from QM activities, are confidential and privileged “These documents or records, under the provisions of 38 U.S.C. 5705 and its implementing regulations. This material shall not be disclosed to anyone without authorization as provided for by that law or its regulations. The statute provides for fines up to $20,000 for unauthorized disclosures.”
POST FALL HUDDLE / AFTER ACTION REVIEW () Nurse Reviewer: Date: Patient Name/ID: Instructions: Hold as soon as possible after the patient fall occurred. Keep the meetings brief; 15 minutes. Involve the patient if possible. Forward completed review to Nurse Manager, then to Patient Safety Manager.(11E) Questions Lessons learned. Why did this patient fall? (Ask 3 times) Was patient at correct fall/injury risk level? Were the appropriate interventions in place? What accounted for the difference? How could the same outcome be avoided the next time? What is the follow up plan? Patient’s account (if able to share) Agreement with the patient for safety (Promise to use call bell; return demo how to use call bell) Type of Fall: ______________________________ Nurse Manager Review: Signature Date_____________________ “These documents or records, or information contained herein which resulted from QM activities, are confidential and privileged under the provisions of 38 U.S.C. 5705 and its implementing regulations. This material shall not be disclosed to anyone without authorization as provided for by that law or its regulations. The statute provides for fines up to $20,000 for unauthorized disclosures.”
POST-FALL-HUDDLE-After-Action-Review-2-2009.docx