Sentinel event reporting form 2026

1. Click ‘Get Form’ to open the sentinel event reporting form in the editor.
2. Begin by entering the 'DATE OF SENTINEL EVENT' and 'REGISTRY NUMBER' at the top of the form. Ensure these details are accurate as they are crucial for tracking.
3. Fill in the 'FACILITY INFORMATION' section, including 'FACILITY LICENSE NUMBER', 'FACILITY NAME', and your name under 'REPORT COMPLETED BY'.
4. In the 'PRIMARY CONTRIBUTING FACTOR(S)' section, check up to four boxes that best describe the factors contributing to the sentinel event. This helps in identifying patterns.
5. Next, indicate any relevant 'CONTRIBUTING DEPARTMENT(S)' by checking up to four boxes that apply. This categorization aids in departmental reviews.
6. For 'CORRECTIVE ACTION(S)', select all applicable actions taken post-event. This is vital for future prevention strategies.
7. Finally, provide any additional comments or lessons learned in the designated sections before submitting your report.

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