Incident Management Policy and Procedure 652.0 KB - Oxleas NHS ...

Date of discharge from most recent inpatient stay if applicableto whom (e.g.GP, none)Date of last contact:Type of contact (outpatient/ home visit)With whomJob titleList DNAs and missed contacts:Narrative ChronologyPlease give full details of what happened and where in the pre-ceding 24 hours (minimum for inpatient)and 3 contacts (community client) leading up to and including the incident. Include immediate actionstaken at the time to address the incident (e.g. telephoned for ambulance, who was informed etc).Indicate, client mental state, observations, medication, staff interventions etc. in timeline order. Pleasealso state source of information (i.e. who completed notes in clinical record or gave an account ofthese details). Please give as much factual detail as possible.Time of incident (Use 24 hour clock):Details:Community/ outpatient contact,By whom:Details:Date:Community/ outpatient contact:By whom:Details:Date:Community/ outpatient contact:By whom:Details:Date:Please continue with any other relevant contacts in this case including other agencies (if known).Actions taken:Please describe any immediate actions taken to ensure patient and staff safety and describe supportgiven to those involved following this incident:Staff support:Relative/ carer supportAre there any other details relevant to this incident ?Please continue.37