Pharmacy incident report template 2025

1. Click ‘Get Form’ to open the pharmacy incident report template in the editor.
2. Begin by filling in the pharmacy details, including the Pharmacy/Branch name and Branch number if applicable. Ensure you provide a reference number from any NRLS report if available.
3. In the Incident details section, enter the date and time of the incident, where it occurred, and a detailed description of what happened. Be factual and avoid opinions.
4. Indicate the degree of harm to the patient by selecting from options such as 'No harm', 'Low', 'Moderate', or 'Severe'.
5. Complete patient details including their name, address, date of birth, sex, and any known disabilities. This information is crucial for understanding patient context.
6. Identify contributing factors by selecting relevant options that may have led to the incident. This helps in analyzing root causes.
7. Describe the medication incident thoroughly, specifying any adverse reactions or errors related to medication administration.
8. Finally, review all sections for accuracy before submitting your report through your designated reporting route.

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