Incident and sentinel event reporting

1. The facility shall have a written policy outlining the documentation of incidents that occur while the resident is in placement. The policy must include: a. A description of an incident as an unplanned occurrence that resulted or could have resulted in injury to an individual or damage to property, specifically involving the public, residents, or agency employees and nonemployees; incidents involving law enforcement, including in the case of a runaway, criminal activity, behavior resulting in harm to others, or restraint injury; and incidents involving outbreak of a serious communicable disease, harassment, violence, and discrimination; and b. Notification must be made to the custodian and parent or guardian immediately or no more than twelve hours; 2. The facility shall have a written policy outlining the documentation of sentinel events that occur while the resident is in placement. The policy must include: a. A description of a sentinel event as an unexpected occurrence involving death or serious physical or psychological injury not related to the natural course of a resident's illness or underlying medical condition, including any process variation for which a reoccurrence would carry a significant chance of a serious adverse outcome, trauma to a resident, attempted suicide by the resident, or inappropriate sexual contact; and b. Notification must be made to the custodian and parent or guardian, and the department immediately or no more than twelve hours; 3. Documentation of an incident or sentinel event must be completed and placed in the resident's record. The report must include: a. Resident's name, age, and sex; b. A description of the incident or event; c. The date, time, and location of the incident or event; d. The name of each employee or nonemployee involved; e. Methods used to address the resident's behavior, including duration of each intervention; f. Detailed description of the technique or approach engaged with the resident at the time of the incident or event; g. Results achieved from methods used to address resident behavior; and h. Injuries received by either the resident, employee, or nonemployee in using physically enforced separation or restraint, how the injuries occurred, and any medical care provided; 4. The facility shall maintain a log of written reports of incidents involving residents; 5. Direct care staff must be given time at the beginning of each shift to be informed of or review incident reports occurring since their last shift; and 6. Employees, nonemployees, and residents must be given time to debrief the incident with clinical staff.