Incident report forms

Page content: Falls report form | Falls report: Residential aged care setting

Falls report form

Developed by: Eastern Access Community Health and Maroondah City Council (based on guidelines developed by Peninsula Health Falls Prevention Service)

Format: Incident report form

This incident report form was developed by Eastern Access Community Health and the Maroondah City Council. It is based on information from the original FRAT Pack developed by the Peninsula Health Falls Prevention Service titled 'Guidelines for inclusion in incident report forms'. (Note: the current FRAT Pack includes a significantly modified falls incident report form.)

The incident report form should be completed immediately following a resident's fall. The staff member who observed the fall or who the fall was reported to should complete their respective parts of the report. All sections of the report should be completed as this information will inform the management plan and reduce the future risk of similar falls.

Availability:

Falls report form (90kb, pdf)

Falls report form (167kb, MS Word)

Falls report: Residential aged care setting

Developed by: Goulburn Valley Health

Format: Incident report form

This detailed two-page incident report form was developed by Goulburn Valley Health and can be used to document the circumstances and consequences of falls. This type of detailed information can be helpful to review patterns of falls over time.

The incident report form should be completed for every fall-related incident. The form can be completed by the staff member who either found the resident after the fall, witnessed the fall, or had the fall reported to them by a resident, visitor or non-medically trained staff member. Upon completion of the report a copy should be placed in the resident's file and the falls register.

Availability:

Falls risk assessment and guidelines (149kb, pdf)

Falls risk assessment and guidelines (222kb, MS Word)