Section 325.21104. Accident records and incident reports.

Rule 1104. An accident record or incident report shall be prepared for each accident or incident involving a patient, personnel, or visitor and shall include all of the following information:

(a)   Name of person involved in accident or incident.

(b)   Date, hour, place, and cause of accident or incident.

(c)   A description of the accident or incident by any observer who shall be identified and a statement of the effect of the accident or incident on the patient and any other individual involved.

(d)    Name  of  physician  notified  and time   of   notification   when appropriate.

(e)      Physician's   statement  regarding  extent  of  injuries,  treatment ordered, and disposition of person involved.

(f)  Corrective measures taken to avoid repetition of accident or incident.

(g)   Record of notification of the person or agency responsible for placing and maintaining the patient in the home, the legal guardian, and, in a case where there is no legal guardian, the designated  representative or next of kin.

History: 1981 AACS.