How to enter an Incident in Safeguard The Safeguard system is accessed via the Cornwall Partnership NHS Foundation Trust intranet site: Select Incident Reporting which will display in following screen: Please report your incident as soon as possible or within 48 hours maximum Incidents are reported so an accurate view of events which can or have caused harm is known. We encourage an open and transparent system of reporting and can use the information to reduce the risk of reoccurrence and identify trends for action. Enter your User ID and Password. This will be the same as you enter for Novell. The Logon to field will default to Safeguard. Press Login to to enter Safeguard:- The first screen entitled „Safeguard Risk Management‟ will show you a colour coded list of incidents summarising what is outstanding for you. This will vary in number and content each time you login as incidents are added and closed. Add an incident Choose either Enter an Incident or New Incident (both do the same thing). A screen similar to the following will display:- Several sections make up the final form, each section identified with a blue band running across the page from left to right e.g. Details of Person completing this form; People Involved in the Incident. Any information which is mandatory will show with a blue background, like the Surname & Forename fields in the example screenshot above. Details of Person completing this form The majority of this section will default and is greyed out. You can enter your Ethnicity or email address. People Involved in the Incident (note this is the only section of the incident report where the people are identified by name). Please add everyone involved in each incident you report i.e. Patient(s), Staff, Visitor(s) or Non Person(s) such as property. A series of questions will be asked on a drop down screen for each highlighted box. Please answer all you can for each person involved and continue doing so until complete Do not assume if you reported the incident, the system will know you are the Staff member involved (as you may not be). If you are involved you must still add your own name in this section You must specify who is the Instigator(s) and Victim(s) for each person involved Patient For patients enter all the information known about them, specifically their NHS Number, Surname, Forename, Sex and Date of Birth so they can be uniquely identified. S taf V istor N o npersonsi.e.P ro perty For each of the people involved, answer all the following questions:Injuries Injuries include physical and emotional. If any injuries were incurred answer Yes to Were there any Injuries and record the details here. Complete the Injury type (e.g. cut, bump, skin tear, shock), Body Part Injured, including whether this is Left, Right, or Both, and Extent. This is particularly important for physical attacks on staff as information is forwarded to NHS Protect (staff details are excluded). Relative Informed & Duty of Candour For any patient safety incident, choose the response to whether a patient/their relative have been informed and then complete the fields with the relevant details. Note it is good practice to inform patients and their relatives when incidents occur. There is also a contractual Duty of Candor which applies for all patient safety incidents reported as a risk rating of moderate or above (although we capture for all levels of incident) Interventions If an intervention was used (MAPA), please complete the Reason, Type of Hold, Position Held, Lead and all staff involved (with the body part they held & MAPA trained status). Seclusion All seclusions must be recorded as such in the Cause Group Seclusion. Please ensure you enter both the start and end dates & times so a seclusion duration can be calculated. These incidents must also have a Cause Group and Cause of Seclusion. Legal Status & Observations Choose the appropriate Mental Health Act (MHA) Status for all Patients. For an informal patient select „informal‟ from the list, otherwise the section the patient was under at the time of the incident. Once all these questions have been answered, more than one person can be added by answering „Yes‟ to Was another Person Involved and completing the details for each one e.g. an incident involving 2 Staff and 1 Patient should have all 3 names entered in this section, with details completed for all 3 What Happened and When Incident date - the date the incident occurred. Incident time - the time the incident occurred (24 hour clock e.g. 17:00 for 5pm). Type of incident - is asking whether the incident was Patient, Staff, Visitor or Property related, and whether it was a near miss or not. To help you determine which, think of who was the victim or was affected. For example if a patient hit a member of Staff, you should choose Staff as the Staff member was the victim. If a Patient self-harmed, choose Patient. If the incident was prevented you choose Near Miss (NRLS definition of near miss:- “an adverse incident that had the potential to cause harm but was prevented and no harm was caused”. This is also a source where lessons can be learned from changes in procedures, processes and systems.) You need to combine these to choose the Type of Incident from the drop down list. Cause Group - is the theme of the incident e.g. Slips, Trips & Falls. It would be advantageous if all incidents could be categorised by one cause group, but this is very often not the case as several types of incidents can be included in one report and it is not always practical to complete several reports for one incident. Therefore the reporter is asked to choose the most significant event and match to a cause group. Cause is a more detailed description e.g. Slips, Trips & Falls – From Standing. Depending on what you choose for Cause Group will restrict what you can chose from Cause as they are linked to one another. Contributory factors – use the drop down menu to identify the factor most relevant. Patient Safety Incident – This will default depending on the Cause you choose. These incidents will be automatically reported to the NRLS withholding any names, therefore it essential that in the body of any free text personal identifiers such as names and abbreviations are not used. RIDDOR reportable – the reporting to the Health and Safety Executive (and in some cases to the Local Authority) of injuries, diseases and dangerous occurrences „which arise out of or in connection with work activities‟. Please contact the Health & Safety Manager, or refer to the RIDDOR Policy if you have any specific queries. Child safeguarding alert sent – an alert was sent. Please ensure the Cause Group related to all these incidents is the appropriate Abuse/DAB e.g. emotional, financial, sexual etc. Do not use „Failure in Safeguard Process‟ unless such a failure has occurred. Adult Safeguarding Alert sent – an alert was sent. Please ensure the Cause Group related to all these incidents is the appropriate Abuse/DAB e.g. emotional, financial, sexual etc. Do not use „Failure in Safeguard Process‟ unless such a failure has occurred. Additional details Remember to keep this anonymous Rapid Tranquilisation – if used Underlying Causes/events - remember to keep this anonymous Where the Incident Happened This section is all about where the incident happened. It should not be confused with where you are based. Simply choose the location of the incident by selecting the values from the drop down boxes Site - IMPORTANT: if an incident occurred at any non CFT site e.g. a patient‟s home, public place, care home, custody suite, in hospital, you must choose this from the list e.g. Patient Home – Community, meaning it occurred under the care of Functional Community Service Line, in a patient‟s own home. Individual Care/Nursing/Residential Homes & Hospitals are not listed so chose the generic description linked to the Service Line e.g. „Hospital – CCD Service Line‟ for a Complex Care & Dementia patient; „Hospital – Community‟ for a Community patient. Department – this will default depending on what you choose for Site. Using the above Community example you will be prompted to choose the appropriate region e.g. Alex House, Banham, Bolitho etc. Service line – this will default and is display only i.e. you cannot amend Specialty – team where the reporter is attached (this may also default) Location of incident – detail of where the incident occurred e.g. dining room, hallway, out in the community Exact location details - If you have the postal address please enter this in the Exact Location details field. Example:- if an incident occurred on Garner Ward you would choose Bodmin Hospital (Site), Garner Ward (Department), Service Line will default to Complex Care & Dementia, Specialty will default to Inpatient Ward CC&D, then choose Location of Incident. Medication If this is a medication incident choose Yes. Ensure the Cause Group is Medication. Process will also give you a variety of choices. Select which best describes the medication incident. This should tally with Detail of Error e.g. Prescribing (Process), then Prescribing – Prescription Not Signed (Detail of Error). IMPORTANT: If the drug is a controlled drug (CD), please ensure you tick the „Is this a Controlled Drug?’ box. Reports are run from this information so it is vital it is checked for all CD incidents. Drug Involved in this Incident must be completed for all Medication incidents. Hereafter you only need to complete the fields which are relevant:- Drug Due/Given – if the incorrect drug was given Date Time Due/Given - wrong date or time given Dosage Due/Given – incorrect dosage Route Due/Given - incorrect route If multiple drugs are involved in one incident select Add New Medication and complete the relevant fields for each. The names of the Checker, Giver, Prescriber is also required where applicable. Medical Devices - If the incident involves a medical device complete this section. The definition of all therapeutic and diagnostic equipment will include manual handling equipment, hospital beds, assistive technology, and thermometers. The Cause Group to choose for these incidents will be Medical Devices, which will allow you to select from a list of related causes, such as unavailability, unsafe/unsuitable. The Device type information will be required by the NRLS for all medical equipment incidents, therefore it is a mandatory field. Witnesses - If any person(s) witnessed the incident please click the Yes button to open this section and record their details. More than one person can be added (add more by choosing Add New Witness as described before for new person). AWOL/Missing Person - The cause group AWOL will allow the reporter to choose one of the following causes:- AWOL, Attempted AWOL, or Failure to Return from Authorised Leave. If a patient is informal and missing, the cause group to choose is Missing Person, which would allow you to record a Cause of Absconder (Informal). Note: if a staff member is missing chose Cause Group Missing and Cause Missing (Staff). It is important to enter all the relevant dates and times known. Remember, if a patient is Informal they will be considered Missing. If the Patient is Detained they will be considered AWOL (Absent Without Leave). Police Involvement - If the police were involved choose Yes to Were the Police involved to display the above screen. You will first be prompted to complete details of who/when the police were contacted. If additionally the police attended, enter all the known information e.g. Officers name and Collar number. If more than one officer attended, you can add more by choosing Add. If you have any further contact details such as telephone numbers or mobiles please enter them. Recommendations – Should you wish to add a recommendation the option is here to do so. There will be a requirement by the person allocated to „manage‟ this incident to approve the recommendations and track the outcome. Save For Later – The save for later option is to enable staff to save the incident and return to it at another time. We would strongly discourage this process unless you do retrieve the incident quickly to complete it. The notification rules referred to earlier i.e. email to „managers‟, are not applied to any incidents „saved for later‟ so no one would be notified of this incident. Incidents held within the „Saved for Later‟ file will be submitted by a Governance member after 48 hours of reporting (if not done so by the reporter beforehand). Submit – chose this to save and submit your incident. This will send an email notification to the persons identified to „manage‟ this incident, or for information and action as required. You have now completed reporting your incident. When the person allocated to manage this incident ‘completes’ it, you will receive a response from them.