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Healthcare Risk Management Checklist: Incident Prevention

Proactively safeguard your healthcare facility. This comprehensive Incident Prevention Checklist streamlines risk assessment, reinforces safety protocols, and minimizes liability - ensuring patient well-being and operational efficiency. Download now for enhanced risk management!

This Template was installed 2 times.

Patient Identification & Verification

1 of 10

Ensuring accurate patient identification throughout the care process to prevent medical errors.

Patient Full Name

Patient Medical Record Number (MRN)

Date of Birth Verification

Photo ID Presented?

Notes/Discrepancies

Insurance Verification Method

Insurance Policy Number

Medication Management

2 of 10

Verifying medication orders, administration, and reconciliation to minimize adverse drug events.

Medication Reconciliation Complete?

Double-Check Count (if applicable)

High-Alert Medication Verification?

Any Discrepancies Noted?

Medication Reconciliation Date

Patient Education Provided?

Upload Medication Reconciliation Form (if required)

Infection Control & Prevention

3 of 10

Adhering to protocols for hand hygiene, sterilization, and isolation precautions to reduce healthcare-associated infections.

Last Hand Hygiene Audit Date

Hand Hygiene Compliance Rate (%)

Type of Disinfectant Used

Notes on Recent Infection Control Concerns/Observations

PPE Used for Isolation Precautions

Sterilization Method Used

Upload Hand Hygiene Audit Report

Equipment Maintenance & Calibration

4 of 10

Ensuring medical equipment is properly maintained, inspected, and calibrated for safe and effective operation.

Last Calibration Date

Calibration Result (e.g., +/- value)

Calibration Method

Calibration Notes/Observations

Next Calibration Due Date

Equipment Serial Number

Calibration Certificate (if applicable)

Emergency Preparedness

5 of 10

Reviewing and updating emergency response plans for various scenarios, including fire, natural disasters, and active shooter situations.

Last Emergency Drill Date

Type of Drill Conducted

Number of Participants in Drill

Drill Observation and Findings

Areas of Improvement Identified

Date of Next Emergency Plan Review

Emergency Contact List (Updated)

Plan Distribution Method

Staff Training & Competency

6 of 10

Verifying staff training records and competency assessments for relevant procedures and protocols.

Employee Name

Training Completion Date

Training Program (e.g., HIPAA, Safety)

Training Hours Completed

Proof of Completion (Certificate)

Competency Level Achieved

Trainer Comments / Observations

Incident Reporting & Analysis

7 of 10

Ensuring a robust system for reporting, investigating, and analyzing incidents to identify root causes and implement corrective actions.

Date of Incident

Time of Incident

Detailed Description of Incident

Incident Type (e.g., Medication Error, Patient Fall)

Number of Patients Involved

Contributing Factors Identified

Departments Involved (select all that apply)

Reporting Staff Signature

Security & Access Control

8 of 10

Implementing and maintaining security measures to protect patient data, prevent unauthorized access to facilities and systems.

Physical Access Control System Status

Number of Active User Accounts

Multi-Factor Authentication (MFA) Implementation

Last Security Audit Date

Summary of Recent Security Vulnerabilities & Remediation Steps

Data Encryption Status (At Rest)

Upload of Access Control Logs (if applicable)

Fall Prevention

9 of 10

Assessing patient fall risks and implementing appropriate preventative measures.

Patient Fall Risk Assessment Score

Patient Weight (lbs)

Vision Impairment?

Use of Assistive Devices?

Specific Fall Risk Factors Noted

Environmental Fall Hazards Present?

Bed/Chair Alarm in Place?

Communication & Handoff Procedures

10 of 10

Standardizing communication protocols during patient handoffs to ensure continuity of care and minimize errors.

Handoff Method Used

Summary of Patient Condition & Concerns

Patient's Current Pain Level (0-10)

Next Scheduled Follow-Up Appointment

Time of Handoff

Medication Changes/Updates

Relevant Lab Results/Diagnostic Findings

Handoff Provider Signature

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