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Medication Error or Near Miss Report & Action Form Health and Social Care Moray

This form is used to report medication errors or near misses in Health and Social Care Moray. It collects information about the incident such as date, location, patient details, medication name, and description of what went wrong. Actions taken in response are also recorded, such as contacting the GP, additional training, or changes to procedures. The overall outcome for the patient's health and lessons learned from the incident are summarized.

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615 views2 pages

Medication Error or Near Miss Report & Action Form Health and Social Care Moray

This form is used to report medication errors or near misses in Health and Social Care Moray. It collects information about the incident such as date, location, patient details, medication name, and description of what went wrong. Actions taken in response are also recorded, such as contacting the GP, additional training, or changes to procedures. The overall outcome for the patient's health and lessons learned from the incident are summarized.

Uploaded by

darning
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOC, PDF, TXT or read online on Scribd
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Medication Error or Near Miss Report & Action Form

Health and Social Care Moray

This form is to be read in conjunction with Medication Guidelines. This should be completed in
conjunction with internal incident reporting procedures.

Date Incident Reported


Date/ Time Incident Occurred
Incident Location
Service User Details
Service User Address
Care Worker Name
Care Worker Team

Indicate at which stage of the process the incident occurred


Prescribing Ordering Pharmacy Dispensing
Receipt Administration Recording
Other:

Medication Name & Description


Regular Yes/No Temporary Yes/No

Details of Incident

What do you think went wrong and why?

Action Taken (e.g. contact GP)

Outcome of Action (e.g. follow advice of GP)

Action taken as a result of error (e.g. further training, clarification of procedure)

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V1.1 (updated 20171115)
Medication Error or Near Miss Report & Action Form
Health and Social Care Moray

Overall Outcome (e.g. Health of service User)

What have you learnt, and what will be done differently as a result of this incident?

Follow up action taken as a result of the incident?

Outcome of further training? (if applicable) (e.g. outcome of the further training, when it
occurred, etc)

Outcome of the QA? (e.g. discussion with the Care Worker, when this happened)

Has Care Worker been provided with a copy of this document? Yes/No

Care Worker signature (if required)

Recording Process Date:


Completed By:
Informed Manager □ Service User Home Updated □ Recorded on Medication Record □
Internal Incident Report Complete □ Date on Agenda for Team Meeting :

Manager Signature Date:

Please email completed form to commcarefileaudit@moray.gov.uk

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V1.1 (updated 20171115)

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