{ "id": -4, "tracker": 4, "title": "Record Patient Safety Events", "pages": [ { "id": -8, "tracker": 7, "name": "CL001", "label": "CL001", "items": [ { "id": -1080, "tracker": 8, "label": "What kind of event do you want to record?", "name": "What kind of event do you want to record?", "input": { "type": "radio", "type_label": "Multiple choice", "placeholder": "", "required": true, "has_actions": true, "validation_error": "", "category": 2, "is_display_case": false, "is_display_summary": false, "default_answer": { "title": "Default Selection", "value": "", "applied": false }, "options": [ { "val": "Incident - Something unexpected or unintended has happened, or failed to happen, that could have or did lead to patient harm for one or more person(s) receiving healthcare.", "code": "1", "example": "Patient safety incidents, including “near misses”. Select this option if you know that something did not go as it should have done and as a direct result the incident could have or did hurt one or more patients.", "example_title": "What does this mean?" }, { "val": "Good Care - An example of Good Care that can be learned from.", "code": "2", "example": "Positive learning opportunities. Select this option if you want to share experiences or learning from things that have gone well whilst delivering care.", "example_title": "What does this mean?" } ], "conditions": [ { "id": -1324, "tracker": 256, "if_word": "1", "percent_match": 0, "if_email": [], "completed": false, "if_value": "2", "hide_page": [ "-10", "-12", "-17", "-22", "-24", "-28", "-34", "-69", "-106", "-162", "-47", "-49", "-56", "-79", "-58", "-61", "-303", "-318", "-328", "-336", "-344", "-352", "-360", "-370", "-378", "-386", "-394", "-402", "-65", "-68", "-72", "-547" ], "action_type": "hide_page" }, { "id": -1778, "tracker": 290, "if_word": "1", "percent_match": 0, "if_email": [], "completed": false, "if_value": "2", "show_page": [ "-1343", "-1601", "-1627", "-1631" ], "action_type": "show_page" }, { "id": -2147, "tracker": 310, "if_word": "1", "percent_match": 0, "if_email": [], "completed": false, "if_value": "1", "hide_page": [ "-1343", "-1460", "-1601", "-1615", "-1627", "-1631", "-1809", "-1991" ], "action_type": "hide_page" }, { "id": -2149, "tracker": 313, "if_word": "1", "percent_match": 0, "if_email": [], "completed": false, "if_value": "1", "show_page": [], "action_type": "show_page" } ] }, "order": 5, "type": "field", "draging": false, "has_over": false, "has_input": true, "hide": false, "disable": false, "good_care": false, "always_show": false, "check_one": false, "gdpr": null, "is_label_hidden": false, "connected_involvement_field": null, "connected_involvement": null, "is_nhs_field": true, "nhs_extension_url": "Event", "hide_in_summary": true } ], "order": 1, "type": "page", "draging": false, "has_over": false, "is_required": false, "allow_only_one": false, "is_required_special": false, "progress_bar_name": "CL001", "is_nhs_hidden": false, "is_nhs_page": true, "is_default_nhs_hidden": false, "is_check_your_answer_type": false, "is_event_summary_type": false, "is_patient_summary_type": false }, { "id": -10, "tracker": 13, "name": "A001", "label": "A001", "items": [ { "id": -11, "tracker": 14, "label": "Which things were involved in the incident?", "name": "Which things were involved in the incident?", "input": { "type": "checkbox", "type_label": "Checkbox", "placeholder": "", "required": true, "has_actions": true, "validation_error": "", "category": 2, "default_answer": { "title": "Default Selections", "value": "", "applied": false }, "options": [ { "val": "Medications", "code": "4" }, { "val": "Devices", "code": "3" }, { "val": "IT Systems or Software", "code": "9" }, { "val": "Buildings or Infrastructure", "code": "13", "example": "- Areas under construction, including scaffolding\n- Fire prevention and response\n- Medical gas supply\n- Heating and ventilation, including overheating\n- Lighting\n- Water supply\n- Power supply\n- Non-medical electrical equipment\n- Building access and car parking\n- Lifts and pulley systems\n- Furniture and bathrooms\n- Physical security of buildings\n- Communications including wifi, phone, mobile phones and bedside TVs\n- Security and structure of the building for patients with dementia\n- Ligature points, window restrictions, and other buildings issues relating to self-harm\n- Other", "example_title": "Click here for examples" }, { "val": "Estates Services", "code": "14", "example": "- Infection control relating to the built environment\n- Hospital food services\n- Cleaning and cleanliness\n- Linen and laundry services\n- Pest control\n- Decontamination of surgical instruments\n- Healthcare waste management\n- Non-emergency patient transport\n- Other", "example_title": "Click here for examples" }, { "val": "Whole blood or Blood components", "code": "11", "example_title": " What is this?", "example": "- ‘’Whole blood” means whole human blood collected from a donor and processed either for transfusion or for further manufacturing;\n- “Blood component” means a therapeutic constituent of human blood (red cells, white cells, platelets and plasma) that can be prepared by various methods" }, { "val": "Blood products", "code": "12", "example": "“Blood products” means any therapeutic product derived from human blood or plasma; examples include Albumin, Immunoglobulins, Anti D and Octoplas.", "example_title": "What is this?" }, { "val": "Tissues or Organs for transplant", "code": "8" }, { "val": "None of the above", "code": "10" } ], "conditions": [ { "id": -19, "tracker": 19, "if_word": "1", "percent_match": 0, "if_email": [], "completed": false, "if_value": "11", "show_page": ["-12"], "action_type": "show_page" }, { "id": -21, "tracker": 21, "if_word": "1", "percent_match": 0, "if_email": [], "completed": false, "if_value": "8", "show_page": ["-17"], "action_type": "show_page" }, { "id": -669, "tracker": 249, "if_word": "1", "percent_match": 0, "if_email": [], "completed": false, "if_value": "4", "show_page": ["-547"], "action_type": "show_page" } ], "has_none_option": true }, "order": 4, "type": "field", "draging": false, "has_over": false, "has_input": true, "hide": false, "disable": false, "good_care": false, "always_show": false, "check_one": false, "is_label_hidden": false, "connected_involvement_field": null, "connected_involvement": null, "sub_label": "Your answer should be based on the information you have at this point. These options act as a trigger for subsequent more detailed questions required by our national patient safety data partners (e.g. MHRA, estate services etc)", "is_nhs_field": true, "nhs_extension_url": "InvolvedAgents", "hide_in_summary": false } ], "order": 3, "type": "page", "draging": false, "has_over": false, "is_required": false, "allow_only_one": false, "is_required_special": false, "progress_bar_name": "A001", "is_nhs_hidden": false, "is_nhs_page": true, "is_default_nhs_hidden": false, "is_check_your_answer_type": false, "is_event_summary_type": false, "is_patient_summary_type": false }, { "id": -12, "tracker": 18, "name": "A018, A019", "label": "A018, A019", "items": [ { "id": -18, "tracker": 19, "label": "Reported blood related events", "name": "Reported blood related events", "input": { "component": "text", "type": "text_block", "type_label": "Text Block", "conditions": [], "font_size": 16, "text_color": "#000000" }, "order": 2, "type": "field", "draging": false, "has_over": false, "has_input": true, "hide": false, "disable": false, "good_care": false, "always_show": false, "check_one": false, "is_label_hidden": false, "connected_involvement_field": null, "connected_involvement": null, "sub_label": "Under the Blood Safety and Quality Regulations (2005 as amended) blood and blood component Serious Adverse Events (SAE) and Serious Adverse Reactions (SAR) are legally required to be reported to the Medicines and Healthcare products Regulatory Authority (MHRA). The Serious Hazards of Transfusion (SHOT) is the UK's independent, professionally led haemovigilance scheme, collecting and analysing anonymised information on adverse events and reactions in blood transfusions from all healthcare organisations in the United Kingdom. The MHRA and SHOT have collaborated to improve haemovigilance reporting by producing an integrated incident reporting process through the Serious Adverse Blood Reactions and Events (SABRE) platform. All SAR and SAE incidents related to the safety and quality of blood must be reported through your local hospital blood bank or blood establishment SABRE representatives.

If you know that this patient safety event has been reported to the MHRA and SHOT but you still wish to continue with the LFPSE submission, please include the SABRE/SHOT report number(s) for linkage.", "is_nhs_field": true, "summary_label": "NHSBT report number", "hide_in_summary": false }, { "id": -20, "tracker": 20, "label": "SABRE report number (Optional)", "name": "SABRE report number (Optional)", "input": { "type": "text", "type_label": "Short Text", "placeholder": "", "required": false, "has_actions": true, "validation_error": "", "category": 1, "default_answer": { "title": "Default Answer", "value": "", "applied": false }, "min_characters": { "title": "Min Characters", "value": "", "applied": false }, "max_characters": { "title": "Max Characters", "value": "", "applied": false }, "conditions": [] }, "order": 3, "type": "field", "draging": false, "has_over": false, "has_input": true, "hide": false, "disable": false, "good_care": false, "always_show": false, "check_one": false, "is_label_hidden": false, "connected_involvement_field": null, "connected_involvement": null, "is_nhs_field": true, "nhs_extension_url": "SabreReportNumber", "summary_label": "SABRE report number", "hide_in_summary": false }, { "id": -2422, "tracker": 21, "label": "SHOT report number (Optional)", "name": "SHOT report number (Optional)", "input": { "type": "text", "type_label": "Short Text", "placeholder": "", "required": false, "has_actions": true, "validation_error": "", "category": 1, "default_answer": { "title": "Default Answer", "value": "", "applied": false }, "min_characters": { "title": "Min Characters", "value": "", "applied": false }, "max_characters": { "title": "Max Characters", "value": "", "applied": false }, "conditions": [] }, "order": 4, "type": "field", "draging": false, "has_over": false, "has_input": true, "hide": false, "disable": false, "good_care": false, "always_show": false, "check_one": false, "is_label_hidden": false, "connected_involvement_field": null, "connected_involvement": null, "is_nhs_field": true, "nhs_extension_url": "ShotReportNumber", "summary_label": "SHOT report number", "hide_in_summary": false } ], "order": 5, "type": "page", "draging": false, "has_over": false, "is_required": false, "allow_only_one": false, "is_required_special": false, "progress_bar_name": "A018, A019", "is_nhs_hidden": true, "is_nhs_page": true, "is_default_nhs_hidden": true, "is_check_your_answer_type": false, "is_event_summary_type": false, "is_patient_summary_type": false }, { "id": -17, "tracker": 22, "name": "A020", "label": "A020", "items": [ { "id": -19, "tracker": 23, "label": "NHS Blood and Transplant report number (Optional)", "name": "NHS Blood and Transplant report number (Optional)", "input": { "type": "text", "type_label": "Short Text", "placeholder": "", "required": false, "has_actions": true, "validation_error": "", "category": 1, "default_answer": { "title": "Default Answer", "value": "", "applied": false }, "min_characters": { "title": "Min Characters", "value": "", "applied": false }, "max_characters": { "title": "Max Characters", "value": "", "applied": false }, "conditions": [] }, "order": 2, "type": "field", "draging": false, "has_over": false, "has_input": true, "hide": false, "disable": false, "good_care": false, "always_show": false, "check_one": false, "is_label_hidden": false, "connected_involvement_field": null, "connected_involvement": null, "sub_label": "Everyone involved in organ donation and transplantation wants to ensure that transplanted organs are as safe as possible for all transplant recipients.

Under the Quality and Safety of Organs Intended for Transplantation Regulations, any incident that involves any undesired, unintended, and/or unexpected occurrence associated with any stage of the donation-to-transplantation pathway that might lead to the transmission of a communicable disease, death, or life-threatening, disabling, or incapacitating conditions for patients, or which results in or prolongs hospitalization or morbidity, must be reported to NHS Blood and Transplant.

If you know that this event has been reported to NHSBT, please provide the NHSBT report number to enable linkage.", "is_nhs_field": true, "nhs_extension_url": "NhsbtReportNumber", "summary_label": "NHS Blood and Transplant report number", "hide_in_summary": false } ], "order": 8, "type": "page", "draging": false, "has_over": false, "is_required": false, "allow_only_one": false, "is_required_special": false, "progress_bar_name": "A020", "is_nhs_hidden": true, "is_nhs_page": true, "is_default_nhs_hidden": true, "is_check_your_answer_type": false, "is_event_summary_type": false, "is_patient_summary_type": false }, { "id": -21, "tracker": 24, "name": "F001", "label": "F001", "items": [ { "id": -23, "tracker": 25, "label": "Describe what happened", "name": "Describe what happened", "input": { "type": "textarea", "type_label": "Long Text", "placeholder": "", "required": true, "has_actions": true, "validation_error": "", "category": 1, "default_answer": { "title": "Default Answer", "value": "", "applied": false }, "min_characters": { "title": "Min Characters", "value": "", "applied": false }, "max_characters": { "title": "Max Characters", "value": "", "applied": false }, "conditions": [] }, "order": 2, "type": "field", "draging": false, "has_over": false, "has_input": true, "hide": false, "disable": false, "good_care": false, "always_show": true, "check_one": false, "is_label_hidden": false, "connected_involvement_field": null, "connected_involvement": null, "sub_label": "Include details of anything you think was important, or might help us learn from what happened. Avoid including any identifiable information such as names of staff or patients here. The national patient safety team focus their primary learning activities on the information provided here, so a full description and sequence of events will contribute to better learning and improvement. Please see here for further details on how we use patient safety data.", "is_nhs_field": true, "nhs_extension_url": "description", "summary_label": "Description", "hide_in_summary": false } ], "order": 9, "type": "page", "draging": false, "has_over": false, "is_required": false, "allow_only_one": false, "is_required_special": false, "progress_bar_name": "F001", "is_nhs_hidden": false, "is_nhs_page": true, "is_default_nhs_hidden": false, "is_check_your_answer_type": false, "is_event_summary_type": false, "is_patient_summary_type": false }, { "id": -22, "tracker": 26, "name": "SC001", "label": "SC001", "items": [ { "id": -24, "tracker": 27, "label": "Does the incident appear to relate to any of these known national safety challenges?", "name": "Does the incident appear to relate to any of these known national safety challenges?", "input": { "type": "checkbox", "type_label": "Checkbox", "placeholder": "", "required": true, "has_actions": true, "validation_error": "", "category": 2, "default_answer": { "title": "Default Selections", "value": "", "applied": false }, "options": [ { "val": "Pressure ulcers", "code": "1" }, { "val": "Falls", "code": "2" }, { "val": "Self harm", "code": "3" }, { "val": "Radiotherapy incident", "code": "4" }, { "val": "Healthcare associated infection", "code": "5" }, { "val": "NHS screening programme incident", "code": "7" }, { "val": "Treatment Delay", "code": "8" }, { "val": "None of the above", "code": "6" } ], "conditions": [ { "id": -27, "tracker": 27, "if_word": "1", "percent_match": 0, "if_email": [], "completed": false, "if_value": "4", "show_page": ["-24"], "action_type": "show_page" }, { "id": -31, "tracker": 31, "if_word": "1", "percent_match": 0, "if_email": [], "completed": false, "if_value": "7", "show_page": ["-28"], "action_type": "show_page" } ], "has_none_option": true }, "order": 2, "type": "field", "draging": false, "has_over": false, "has_input": true, "hide": false, "disable": false, "good_care": false, "always_show": false, "check_one": false, "is_label_hidden": false, "connected_involvement_field": null, "connected_involvement": null, "sub_label": " This list is used to identify those incidents which relate to national programmes of work; though all events are used to contribute to national learning. Your answer should be based on the information you have at this point, and can be changed if further information becomes available.", "is_nhs_field": true, "nhs_extension_url": "SafetyChallenges", "summary_label": "Safety challenges", "hide_in_summary": false } ], "order": 21, "type": "page", "draging": false, "has_over": false, "is_required": false, "allow_only_one": false, "is_required_special": false, "progress_bar_name": "SC001", "is_nhs_hidden": false, "is_nhs_page": true, "is_default_nhs_hidden": false, "is_check_your_answer_type": false, "is_event_summary_type": false, "is_patient_summary_type": false }, { "id": -24, "tracker": 30, "name": "SC002", "label": "SC002", "items": [ { "id": -26, "tracker": 31, "label": "What is the radiotherapy error code?", "name": "What is the radiotherapy error code?", "input": { "type": "text", "type_label": "Short Text", "placeholder": "TSRT9 -", "required": true, "has_actions": true, "validation_error": "", "category": 1, "default_answer": { "title": "Default Answer", "value": "", "applied": false }, "min_characters": { "title": "Min Characters", "value": "", "applied": false }, "max_characters": { "title": "Max Characters", "value": "", "applied": false }, "conditions": [] }, "order": 2, "type": "field", "draging": false, "has_over": false, "has_input": true, "hide": false, "disable": false, "good_care": false, "always_show": false, "check_one": false, "is_label_hidden": false, "connected_involvement_field": null, "connected_involvement": null, "sub_label": "For example, Level 2 / 13ff / 13cc / 13dd / MD13hh / CF3a / CF2c / CF1c", "is_nhs_field": true, "nhs_extension_url": "RadiotherapyIncidentCode", "hide_in_summary": false }, { "id": -34, "tracker": 32, "label": "Guidance on the radiotherapy taxonomy and its application", "name": "Guidance on the radiotherapy taxonomy and its application", "input": { "component": "text", "type": "text_block", "type_label": "Text Block", "conditions": [], "hyperlink": { "title": "Make Hyperlink ?", "value": "https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/579541/DL_guidance_finalNB211216.pdf", "applied": true }, "font_size": 16, "text_color": "#000000" }, "order": 3, "type": "field", "draging": false, "has_over": false, "has_input": true, "hide": false, "disable": false, "good_care": false, "always_show": false, "check_one": false, "is_label_hidden": false, "connected_involvement_field": null, "connected_involvement": null, "is_nhs_field": true, "hide_in_summary": false } ], "order": 22, "type": "page", "draging": false, "has_over": false, "is_required": false, "allow_only_one": false, "is_required_special": false, "progress_bar_name": "SC002", "is_nhs_hidden": true, "is_nhs_page": true, "is_default_nhs_hidden": true, "is_check_your_answer_type": false, "is_event_summary_type": false, "is_patient_summary_type": false }, { "id": -28, "tracker": 33, "name": "SC003", "label": "SC003", "items": [ { "id": -30, "tracker": 34, "label": "What is the Marvin reference number? (Optional)", "name": "What is the Marvin reference number? (Optional)", "input": { "type": "text", "type_label": "Short Text", "placeholder": "", "required": false, "has_actions": true, "validation_error": "", "category": 1, "default_answer": { "title": "Default Answer", "value": "", "applied": false }, "min_characters": { "title": "Min Characters", "value": "", "applied": false }, "max_characters": { "title": "Max Characters", "value": "", "applied": false }, "conditions": [] }, "order": 2, "type": "field", "draging": false, "has_over": false, "has_input": true, "hide": false, "disable": false, "good_care": false, "always_show": false, "check_one": false, "is_label_hidden": false, "connected_involvement_field": null, "connected_involvement": null, "sub_label": "Safety incidents and serious incidents that occur in the delivery of an NHS screening programme should be notified to the regional Public Health England Screening Quality Assurance Service (SQAS) and to the regional NHSE commissioner. Please refer to national guidance for information. Further advice can also be obtained from PHE’s national screening helpdesk who can be contacted on 020 3682 0890 or via the online form.

If you know that this event has been reported to SQAS and the NHSE commissioners, please include the Marvin reference number in the field below to enable linkage.", "is_nhs_field": true, "nhs_extension_url": "MarvinReferenceNumber", "summary_label": "Marvin reference number", "hide_in_summary": false } ], "order": 23, "type": "page", "draging": false, "has_over": false, "is_required": false, "allow_only_one": false, "is_required_special": false, "progress_bar_name": "SC003", "is_nhs_hidden": true, "is_nhs_page": true, "is_default_nhs_hidden": true, "is_check_your_answer_type": false, "is_event_summary_type": false, "is_patient_summary_type": false }, { "id": -34, "tracker": 35, "name": "T001", "label": "T001", "items": [ { "id": -36, "tracker": 36, "label": "Did the incident happen today?", "name": "Did the incident happen today?", "input": { "type": "radio", "type_label": "Multiple choice", "placeholder": "", "required": true, "has_actions": true, "validation_error": "", "category": 2, "default_answer": { "title": "Default Selection", "value": "", "applied": false }, "options": [ { "val": "Yes", "code": "y" }, { "val": "No", "code": "n" }, { "val": "I don't know", "code": "u" } ], "conditions": [ { "id": -183, "tracker": 183, "if_word": "1", "percent_match": 0, "if_email": [], "completed": false, "if_value": "n", "show_page": ["-69"], "action_type": "show_page" }, { "id": -189, "tracker": 189, "if_word": "1", "percent_match": 0, "if_email": [], "completed": false, "if_value": "u", "show_page": ["-106"], "action_type": "show_page" }, { "id": -74, "tracker": 74, "if_word": "1", "percent_match": 0, "if_email": [], "completed": false, "value": { "page": "-69", "action": "set_todays_date" }, "if_value": "y", "action_type": "complex" } ] }, "order": 2, "type": "field", "draging": false, "has_over": false, "has_input": true, "hide": false, "disable": false, "good_care": false, "always_show": false, "check_one": false, "is_label_hidden": false, "connected_involvement_field": null, "connected_involvement": null, "is_nhs_field": true, "nhs_extension_url": "IncidentOccurredToday", "hide_in_summary": false } ], "order": 24, "type": "page", "draging": false, "has_over": false, "is_required": false, "allow_only_one": false, "is_required_special": false, "progress_bar_name": "T001", "is_nhs_hidden": false, "is_nhs_page": true, "is_default_nhs_hidden": false, "is_check_your_answer_type": false, "is_event_summary_type": false, "is_patient_summary_type": false }, { "id": -69, "tracker": 40, "name": "T005", "label": "T005", "items": [ { "id": -71, "tracker": 41, "label": "What was the date of the incident?", "name": "What was the date of the incident?", "input": { "type": "date", "type_label": "Date", "placeholder": "", "required": false, "has_actions": true, "show_day":true, "validation_error": "", "category": 1, "default_answer": { "title": "Default Answer", "value": "", "applied": false }, "min_date": { "title": "Min Date", "value": 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"percent_match": 0, "if_email": [], "completed": false, "if_value": "I don't know", "show_page": ["-106"], "action_type": "show_page" }, { "id": -3989, "tracker": 347, "if_word": "1", "percent_match": 0, "if_email": [], "completed": false, "if_value": "I don't know", "action_type": "disable_question", "disable_question": ["-71"] } ] }, "order": 4, "type": "field", "draging": false, "has_over": false, "has_input": true, "hide": false, "disable": false, "good_care": false, "always_show": false, "check_one": false, "is_label_hidden": true, "connected_involvement_field": null, "connected_involvement": null, "is_nhs_field": true, "hide_in_summary": true } ], "order": 26, "type": "page", "draging": false, "has_over": false, "is_required": true, "allow_only_one": true, "is_required_special": false, "progress_bar_name": "T005", "is_nhs_hidden": true, "is_nhs_page": true, "is_default_nhs_hidden": true, "is_check_your_answer_type": false, "is_event_summary_type": false, 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["-318", "-328", "-336", "-344"], "action_type": "hide_page" }, { "id": -43232, "tracker": 363, "if_word": "1", "percent_match": 0, "if_email": [], "completed": false, "if_value": "10 or more", "hide_page": ["-318", "-328", "-336", "-344"], "action_type": "hide_page" } ] }, "order": 2, "type": "field", "draging": false, "has_over": false, "has_input": true, "hide": false, "disable": false, "good_care": false, "always_show": false, "check_one": false, "gdpr": null, "is_label_hidden": false, "connected_involvement_field": null, "connected_involvement": null, "is_nhs_field": true, "nhs_extension_url": "NoOfPatients", "summary_label": "Number of patients involved", "hide_in_summary": false }, { "id": -70, "tracker": 79, "label": "Add field name", "name": "Add field name", "input": { "component": "text", "type": "text_block", "type_label": "Text Block", "conditions": [], "hyperlink": { "title": "Make Hyperlink ?", "value": "", "applied": false }, "font_size": 16, "text_color": "#000000" }, 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"label": "Patient Age", "items": [ { "id": -305, "tracker": 81, "label": "Patient Details", "name": "Patient Details", "input": { "component": "h3", "type": "text_block", "type_label": "Heading 3", "conditions": [], "hyperlink": { "title": "Make Hyperlink ?", "value": "", "applied": false }, "font_size": 24, "text_color": "#000000" }, "order": 2, "type": "field", "draging": false, "has_over": false, "has_input": true, "hide": false, "disable": false, "good_care": false, "always_show": false, "check_one": false, "is_label_hidden": false, "connected_involvement_field": null, "connected_involvement": null, "sub_label": "The way we collect data on protected characteristics is changing. Please provide the following information.", "hide_in_summary": true }, { "id": -307, "tracker": 82, "label": "What was the patient's age at the time of the incident?", "name": "What was the patient's age at the time of the incident?", "input": { "type": "radio", "type_label": "Multiple choice", "placeholder": "", "required": true, "has_actions": true, "validation_error": "", "category": 2, "default_answer": { "title": "Default Selection", "value": "", "applied": false }, "options": [ { "val": "Over one year old" }, { "val": "At least one month old but less than one year" }, { "val": "Less than one month old" }, { "val": "I don't know but I could give an estimate" }, { "val": "I don't know and I am not able to give an estimate" } ], "conditions": [ { "id": -537, "tracker": 226, "if_word": "1", "percent_match": 0, "if_email": [], "completed": false, "if_value": "Over one year old", "show_page": ["-318", "-352", "-360"], "action_type": "show_page" }, { "id": -538, "tracker": 227, "if_word": "1", "percent_match": 0, "if_email": [], "completed": false, "if_value": "At least one month old but less than one year", "show_page": ["-328", "-352", "-360"], "action_type": "show_page" }, { "id": -539, "tracker": 228, "if_word": "1", "percent_match": 0, "if_email": [], "completed": false, "if_value": "Less than one month old", "show_page": ["-336", "-352", "-360"], "action_type": "show_page" }, { "id": -540, "tracker": 229, "if_word": "1", "percent_match": 0, "if_email": [], "completed": false, "if_value": "I don't know but I could give an estimate", "show_page": ["-344", "-352", "-360"], "action_type": "show_page" }, { "id": -2347, "tracker": 324, "if_word": "1", "percent_match": 0, "if_email": [], "completed": false, "if_value": "Over one year old", "hide_page": ["-328", "-336", "-344"], "action_type": "hide_page" }, { "id": -2348, "tracker": 325, "if_word": "1", "percent_match": 0, "if_email": [], "completed": false, "if_value": "At least one month old but less than one year", "hide_page": ["-318", "-336", "-344"], "action_type": "hide_page" }, { "id": -2351, "tracker": 328, "if_word": "1", "percent_match": 0, "if_email": [], "completed": false, "if_value": "Less than one month old", "hide_page": ["-318", "-328", "-344"], "action_type": "hide_page" }, { "id": -2352, "tracker": 329, "if_word": "1", "percent_match": 0, "if_email": [], "completed": false, "if_value": "I don't know but I could give an estimate", "hide_page": ["-318", "-328", "-336"], "action_type": "hide_page" } ] }, "order": 3, "type": "field", "draging": false, "has_over": false, "has_input": true, "hide": false, "disable": false, "good_care": false, "always_show": false, "check_one": false, "gdpr": null, "is_label_hidden": false, "connected_involvement_field": null, "connected_involvement": null, "is_nhs_field": true, "nhs_extension_url": "PatientAgeCustom", "summary_label": "Patient Age", "hide_in_summary": true } ], "order": 35, "type": "page", "draging": false, "has_over": false, "is_required": false, "allow_only_one": false, "is_required_special": false, "progress_bar_name": "Patient Age", "is_nhs_hidden": false, "is_nhs_page": true, "is_default_nhs_hidden": false, "is_check_your_answer_type": false, "is_event_summary_type": false, "is_patient_summary_type": false }, { "id": -318, "tracker": 91, "name": "P004 = Age value Y", "label": "P004 = Age value Y", "items": [ { "id": -320, "tracker": 92, "label": "Patient Details", "name": "Patient Details", "input": { "component": "h3", "type": "text_block", "type_label": "Heading 3", "conditions": [], "hyperlink": { "title": "Make Hyperlink ?", "value": "", "applied": false }, "font_size": 24, "text_color": "#000000" }, "order": 2, "type": "field", "draging": false, "has_over": false, "has_input": true, "hide": false, "disable": false, "good_care": false, "always_show": false, "check_one": false, "is_label_hidden": false, "connected_involvement_field": null, "connected_involvement": null, "hide_in_summary": true }, { "id": -325, "tracker": 93, "label": "What was the patient's age in years at the time of the incident?", "name": "What was the patient's age in years at the time of the incident?", "input": { "type": "number", "type_label": "Number", "placeholder": "X Years", "required": true, "has_actions": true, "validation_error": "", "category": 1, "default_answer": { "title": "Default Answer", "value": "", "applied": false }, "min_number": { "title": "Min", "value": "", "applied": false }, "max_number": { "title": "Max", "value": "", "applied": false }, "conditions": [] }, "order": 3, "type": "field", "draging": false, "has_over": false, "has_input": true, "hide": false, "disable": false, "good_care": false, "always_show": false, "check_one": false, "is_label_hidden": false, "connected_involvement_field": null, "connected_involvement": null, "is_nhs_field": true, "nhs_extension_url": "PatientAgeYears", "summary_label": "Patient Age in Years", "hide_in_summary": true } ], "order": 36, "type": "page", "draging": false, "has_over": false, "is_required": false, "allow_only_one": false, "is_required_special": false, "progress_bar_name": "P004 = Age value Y", "is_nhs_hidden": true, "is_nhs_page": true, "is_default_nhs_hidden": true, "is_check_your_answer_type": false, "is_event_summary_type": false, "is_patient_summary_type": false }, { "id": -328, "tracker": 94, "name": "P004 = Age value M", "label": "P004 = Age value M", "items": [ { "id": -330, "tracker": 95, "label": "Patient Details", "name": "Patient Details", "input": { "component": "h3", "type": "text_block", "type_label": "Heading 3", "conditions": [], "hyperlink": { "title": "Make Hyperlink ?", "value": "", "applied": false }, "font_size": 24, "text_color": "#000000" }, "order": 2, "type": "field", "draging": false, "has_over": false, "has_input": true, "hide": false, "disable": false, "good_care": false, "always_show": false, "check_one": false, "is_label_hidden": false, "connected_involvement_field": null, "connected_involvement": null, "hide_in_summary": true }, { "id": -333, "tracker": 96, "label": "What was the patient's age in months at the time of the incident?", "name": "What was the patient's age in months at the time of the incident?", "input": { "type": "number", "type_label": "Number", "placeholder": "X Months", "required": true, "has_actions": true, "validation_error": "", "category": 1, "default_answer": { "title": "Default Answer", "value": "", "applied": false }, "min_number": { "title": "Min", "value": "", "applied": false }, "max_number": { "title": "Max", "value": "", "applied": false }, "conditions": [ { "id": -2353, "tracker": 334, "if_word": "1", "percent_match": 0, "if_email": [], "completed": false, "value": 0, "if_value": "greater_then", "show_page": ["-352"], "action_type": "show_page" } ] }, "order": 3, "type": "field", "draging": false, "has_over": false, "has_input": true, "hide": false, "disable": false, "good_care": false, "always_show": false, "check_one": false, "is_label_hidden": false, "connected_involvement_field": null, "connected_involvement": null, "is_nhs_field": true, "nhs_extension_url": "PatientAgeMonths", "summary_label": "Patient Age in Months", "hide_in_summary": true } ], "order": 37, "type": "page", "draging": false, "has_over": false, "is_required": false, "allow_only_one": false, "is_required_special": false, "progress_bar_name": "P004 = Age value M", "is_nhs_hidden": true, "is_nhs_page": true, "is_default_nhs_hidden": true, "is_check_your_answer_type": false, "is_event_summary_type": false, "is_patient_summary_type": false }, { "id": -336, "tracker": 98, "name": "P004 = Age value D", "label": "P004 = Age value D", "items": [ { "id": -338, "tracker": 99, "label": "Patient Details", "name": "Patient Details", "input": { "component": "h3", "type": "text_block", "type_label": "Heading 3", "conditions": [], "hyperlink": { "title": "Make Hyperlink ?", "value": "", "applied": false }, "font_size": 24, "text_color": "#000000" }, "order": 2, "type": "field", "draging": false, "has_over": false, "has_input": true, "hide": false, "disable": false, "good_care": false, "always_show": false, "check_one": false, "is_label_hidden": false, "connected_involvement_field": null, "connected_involvement": null, "hide_in_summary": true }, { "id": -341, "tracker": 100, "label": "What was the patient's age in days at the time of the incident?", "name": "What was the patient's age in days at the time of the incident?", "input": { "type": "number", "type_label": "Number", "placeholder": "X Days", "required": true, "has_actions": true, "validation_error": "", "category": 1, "default_answer": { "title": "Default Answer", "value": "", "applied": false }, "min_number": { "title": "Min", "value": "", "applied": false }, "max_number": { "title": "Max", "value": "", "applied": false }, "conditions": [ { "id": -2355, "tracker": 336, "if_word": "1", "percent_match": 0, "if_email": [], "completed": false, "value": 0, "if_value": "greater_then", "show_page": ["-352"], "action_type": "show_page" } ] }, "order": 3, "type": "field", "draging": false, "has_over": false, "has_input": true, "hide": false, "disable": false, "good_care": false, "always_show": false, "check_one": false, "is_label_hidden": false, "connected_involvement_field": null, "connected_involvement": null, "is_nhs_field": true, "nhs_extension_url": "PatientAgeDays", "summary_label": "Patient Age in Days", "hide_in_summary": true } ], "order": 38, "type": "page", "draging": false, "has_over": false, "is_required": false, "allow_only_one": false, "is_required_special": false, "progress_bar_name": "P004 = Age value D", "is_nhs_hidden": true, "is_nhs_page": true, "is_default_nhs_hidden": true, "is_check_your_answer_type": false, "is_event_summary_type": false, "is_patient_summary_type": false }, { "id": -344, "tracker": 102, "name": "P007 = Estimated age", "label": "P007 = Estimated age", "items": [ { "id": -346, "tracker": 103, "label": "Patient Details", "name": "Patient Details", "input": { "component": "h3", "type": "text_block", "type_label": "Heading 3", "conditions": [], "hyperlink": { "title": "Make Hyperlink ?", "value": "", "applied": false }, "font_size": 24, "text_color": "#000000" }, "order": 2, "type": "field", "draging": false, "has_over": false, "has_input": true, "hide": false, "disable": false, "good_care": false, "always_show": false, "check_one": false, "is_label_hidden": false, "connected_involvement_field": null, "connected_involvement": null, "hide_in_summary": true }, { "id": -349, "tracker": 104, "label": "Estimate the patient's age", "name": "Estimate the patient's age", "input": { "type": "radio", "type_label": "Multiple choice", "placeholder": "", "required": true, "has_actions": true, "validation_error": "", "category": 2, "default_answer": { "title": "Default Selection", "value": "", "applied": false }, "options": [ { "val": "0-14 days", "code": "1" }, { "val": "15-28 days", "code": "2" }, { "val": "1-11 months", "code": "3" }, { "val": "1-4 years", "code": "4" }, { "val": "5-9 years", "code": "5" }, { "val": "10-15 years", "code": "6" }, { "val": "16 and 17 years", "code": "7" }, { "val": "18-25 years", "code": "8" }, { "val": "26-45 years", "code": "9" }, { "val": "46-65 years", "code": "10" }, { "val": "66-85 years", "code": "11" }, { "val": "85+ years", "code": "12" } ], "conditions": [] }, "order": 3, "type": "field", "draging": false, "has_over": false, "has_input": true, "hide": false, "disable": false, "good_care": false, "always_show": false, "check_one": false, "gdpr": null, "is_label_hidden": false, "connected_involvement_field": null, "connected_involvement": null, "is_nhs_field": true, "nhs_extension_url": "AgeBracket", "summary_label": "Patient Estimated Age", "hide_in_summary": true } ], "order": 39, "type": "page", "draging": false, "has_over": false, "is_required": false, "allow_only_one": false, "is_required_special": false, "progress_bar_name": "P007 = Estimated age", "is_nhs_hidden": true, "is_nhs_page": true, "is_default_nhs_hidden": true, "is_check_your_answer_type": false, "is_event_summary_type": false, "is_patient_summary_type": false }, { "id": -352, "tracker": 105, "name": "P009", "label": "P009", "items": [ { "id": -354, "tracker": 106, "label": "Patient Details", "name": "Patient Details", "input": { "component": "h3", "type": "text_block", "type_label": "Heading 3", "conditions": [], "hyperlink": { "title": "Make Hyperlink ?", "value": "", "applied": false }, "font_size": 24, "text_color": "#000000" }, "order": 2, "type": "field", "draging": false, "has_over": false, "has_input": true, "hide": false, "disable": false, "good_care": false, "always_show": false, "check_one": false, "is_label_hidden": false, "connected_involvement_field": null, "connected_involvement": null, "hide_in_summary": true }, { "id": -357, "tracker": 107, "label": "What is the patient's gender?", "name": "What is the patient's gender?", "input": { "type": "radio", "type_label": "Multiple choice", "placeholder": "", "required": true, "has_actions": true, "validation_error": "", "category": 2, "default_answer": { "title": "Default Selection", "value": "", "applied": false }, "options": [ { "val": "Female (including trans woman)", "code": "1" }, { "val": "Male (including trans man)", "code": "2" }, { "val": "Not stated (asked but declined to provide a response)", "code": "3" }, { "val": "Other (not listed)", "code": "4" }, { "val": "Non-binary", "code": "5" } ], "conditions": [] }, "order": 3, "type": "field", "draging": false, "has_over": false, "has_input": true, "hide": false, "disable": false, "good_care": false, "always_show": false, "check_one": false, "is_label_hidden": false, "connected_involvement_field": null, "connected_involvement": null, "sub_label": "Gender is self-identified, and may be in their records, or you can ask the patient. If this information is not available, please select ‘I don’t know’", "is_nhs_field": true, "nhs_extension_url": "Gender", "summary_label": "Patient Gender", "hide_in_summary": true }, { "id": -670, "tracker": 108, "label": "Is the patient's gender identity the same as the sex they were registered with at birth?", "name": "Is the patient's gender identity the same as the sex they were registered with at birth?", "input": { "type": "radio", "type_label": "Multiple choice", "placeholder": "", "required": true, "has_actions": true, "validation_error": "", "category": 2, "default_answer": { "title": "Default Selection", "value": "", "applied": false }, "options": [ { "val": "Yes", "code": "1" }, { "val": "No", "code": "2" }, { "val": "Not stated", "code": "3" }, { "val": "I don't know", "code": "4" } ], "conditions": [] }, "order": 4, "type": "field", "draging": false, "has_over": false, "has_input": true, "hide": false, "disable": false, "good_care": false, "always_show": false, "check_one": false, "is_label_hidden": false, "connected_involvement_field": null, "connected_involvement": null, "is_nhs_field": true, "nhs_extension_url": "GenderSameAsAtBirth", "summary_label": "Is the patient's gender identity the same as the sex they were registered with at birth?", "hide_in_summary": true } ], "order": 40, "type": "page", "draging": false, "has_over": false, "is_required": false, "allow_only_one": false, "is_required_special": false, "progress_bar_name": "P009", "is_nhs_hidden": false, "is_nhs_page": true, "is_default_nhs_hidden": false, "is_check_your_answer_type": false, "is_event_summary_type": false, "is_patient_summary_type": false }, { "id": -360, "tracker": 109, "name": "P028", "label": "P028", "items": [ { "id": -362, "tracker": 110, "label": "Patient Details", "name": "Patient Details", "input": { "component": "h3", "type": "text_block", "type_label": "Heading 3", "conditions": [], "hyperlink": { "title": "Make Hyperlink ?", "value": "", "applied": false }, "font_size": 24, "text_color": "#000000" }, "order": 2, "type": "field", "draging": false, "has_over": false, "has_input": true, "hide": false, "disable": false, "good_care": false, "always_show": false, "check_one": false, "is_label_hidden": false, "connected_involvement_field": null, "connected_involvement": null, "hide_in_summary": true }, { "id": -365, "tracker": 111, "label": "What is the patient's self-identified ethnicity? (Optional)", "name": "What is the patient's self-identified ethnicity? (Optional)", "input": { "type": "radio", "type_label": "Multiple choice", "placeholder": "", "required": false, "has_actions": true, "validation_error": "", "category": 2, "default_answer": { "title": "Default Selection", "value": "", "applied": false }, "options": [ { "val": "English, Welsh, Scottish, Northern Irish or British", "code": "11", "label": "White" }, { "val": "Irish", "code": "12" }, { "val": "Any other White background", "code": "13" }, { "val": "White and Black Caribbean", "code": "21", "label": "Mixed or Multiple ethnic groups" }, { "val": "White and Black African", "code": "22" }, { "val": "White and Asian", "code": "23" }, { "val": "Any other mixed or multiple ethnic background", "code": "24" }, { "val": "Indian", "code": "31", "label": "Asian or Asian British" }, { "val": "Pakistani", "code": "32" }, { "val": "Bangladeshi", "code": "33" }, { "val": "Chinese", "code": "34" }, { "val": "Any other Asian background", "code": "35" }, { "val": "African", "code": "41", "label": "Black, African, Caribbean or Black British" }, { "val": "Caribbean", "code": "42" }, { "val": "Any other Black, African or Caribbean background", "code": "43" }, { "val": "Any other ethnic group", "code": "51", "label": "Other Options" }, { "val": "I don't know", "code": "52" } ], "conditions": [] }, "order": 3, "type": "field", "draging": false, "has_over": false, "has_input": true, "hide": false, "disable": false, "good_care": false, "always_show": false, "check_one": false, "is_label_hidden": false, "connected_involvement_field": null, "connected_involvement": null, "sub_label": "This may be in their record, or you can ask them or a family member. If this information has not been provided by the patient or their family, please select ‘I don’t know’.", "is_nhs_field": true, "nhs_extension_url": "PatientEthnicity", "summary_label": "Patient Ethnicity", "hide_in_summary": true } ], "order": 41, "type": "page", "draging": false, "has_over": false, "is_required": false, "allow_only_one": false, "is_required_special": false, "progress_bar_name": "P028", "is_nhs_hidden": false, "is_nhs_page": true, "is_default_nhs_hidden": false, "is_check_your_answer_type": false, "is_event_summary_type": false, "is_patient_summary_type": false }, { "id": -370, "tracker": 112, "name": "OT001", "label": "OT001", "items": [ { "id": -372, "tracker": 113, "label": "Patient Details", "name": "Patient Details", "input": { "component": "h3", "type": "text_block", "type_label": "Heading 3", "conditions": [], "hyperlink": { "title": "Make Hyperlink ?", "value": "", "applied": false }, "font_size": 24, "text_color": "#000000" }, "order": 2, "type": "field", "draging": false, "has_over": false, "has_input": true, "hide": false, "disable": false, "good_care": false, "always_show": false, "check_one": false, "is_label_hidden": false, "connected_involvement_field": null, "connected_involvement": null, "hide_in_summary": true }, { "id": -375, "tracker": 114, "label": "To what extent was the patient physically harmed (including pain) in this incident?", "name": "To what extent was the patient physically harmed (including pain) in this incident?", "input": { "type": "radio", "type_label": "Multiple choice", "placeholder": "", "required": true, "has_actions": true, "validation_error": "", "category": 2, "default_answer": { "title": "Default Selection", "value": "", "applied": false }, "options": [ { "val": "No physical harm", "code": "5" }, { "val": "Low physical harm", "code": "4", "example": "Low physical harm is when all of the following apply:
", "example_title": "What does this mean?" }, { "val": "Moderate physical harm", "code": "3", "example": "Moderate harm is when at least one of the following apply:
", "example_title": "What does this mean?" }, { "val": "Severe physical harm", "code": "2", "example": "Severe harm is when at least one of the following apply:
", "example_title": "What does this mean?" }, { "val": "Fatal", "code": "1", "example": "You should select this option if, at the time of reporting, the patient has died and the incident that you are recording may have contributed to the death, including stillbirth or pregnancy loss. You will have the option later to estimate to what extent it is considered the patient safety incident contributed to the death.", "example_title": "What does this mean?" } ], "conditions": [ { "id": -545, "tracker": 238, "if_word": "1", "percent_match": 0, "if_email": [], "completed": false, "if_value": "5", "show_page": ["-378"], "action_type": "show_page" }, { "id": -547, "tracker": 240, "if_word": "1", "percent_match": 0, "if_email": [], "completed": false, "if_value": "4", "show_page": ["-378"], "action_type": "show_page" }, { "id": -548, "tracker": 241, "if_word": "1", "percent_match": 0, "if_email": [], "completed": false, "if_value": "3", "show_page": ["-378", "-394"], "action_type": "show_page" }, { "id": -549, "tracker": 242, "if_word": "1", "percent_match": 0, "if_email": [], "completed": false, "if_value": "2", "show_page": ["-378", "-394"], "action_type": "show_page" }, { "id": -5261, "tracker": 1122, "if_word": "1", "percent_match": 0, "if_email": [], "completed": false, "if_value": "1", "show_page": ["-394"], "action_type": "show_page" }, { "id": -43225, "tracker": 354, "if_word": "1", "percent_match": 0, "if_email": [], "completed": false, "if_value": "1", "hide_page": ["-378"], "action_type": "hide_page" }, { "id": -43225, "tracker": 356, "if_word": "1", "percent_match": 0, "if_email": [], "completed": false, "if_value": "5", "hide_page": ["-394"], "action_type": "hide_page" }, { "id": -43226, "tracker": 357, "if_word": "1", "percent_match": 0, "if_email": [], "completed": false, "if_value": "4", "hide_page": ["-394"], "action_type": "hide_page" } ] }, "order": 3, "type": "field", "draging": false, "has_over": false, "has_input": true, "hide": false, "disable": false, "good_care": false, "always_show": false, "check_one": false, "is_label_hidden": false, "connected_involvement_field": null, "connected_involvement": null, "sub_label": "Your answer should be based on the information you have at this point, and can be changed if further information becomes available.

If a death has occurred and you are not aware of any patient safety incident that preceded the death (including stillbirth or pregnancy loss) but want to notify others so that Learning from Deaths or other standard reviews can be conducted, please return to the start and record a ‘Something routinely reported locally that at this time does not appear to be a patient safety incident but may have been preceded by one’ rather than a patient safety incident.", "is_nhs_field": true, "nhs_extension_url": "PhysicalHarm", "summary_label": "Patient Physical Harm", "hide_in_summary": true } ], "order": 42, "type": "page", "draging": false, "has_over": false, "is_required": false, "allow_only_one": false, "is_required_special": false, "progress_bar_name": "OT001", "is_nhs_hidden": true, "is_nhs_page": true, "is_default_nhs_hidden": true, "is_check_your_answer_type": false, "is_event_summary_type": false, "is_patient_summary_type": false }, { "id": -378, "tracker": 123, "name": "OT002", "label": "OT002", "items": [ { "id": -380, "tracker": 124, "label": "Patient Details", "name": "Patient Details", "input": { "component": "h3", "type": "text_block", "type_label": "Heading 3", "conditions": [], "hyperlink": { "title": "Make Hyperlink ?", "value": "", "applied": false }, "font_size": 24, "text_color": "#000000" }, "order": 2, "type": "field", "draging": false, "has_over": false, "has_input": true, "hide": false, "disable": false, "good_care": false, "always_show": false, "check_one": false, "is_label_hidden": false, "connected_involvement_field": null, "connected_involvement": null, "hide_in_summary": true }, { "id": -381, "tracker": 125, "label": "To what extent was the patient psychologically harmed in this incident?", "name": "To what extent was the patient psychologically harmed in this incident?", "input": { "type": "radio", "type_label": "Multiple choice", "placeholder": "", "required": true, "has_actions": true, "validation_error": "", "category": 2, "default_answer": { "title": "Default Selection", "value": "", "applied": false }, "options": [ { "val": "No psychological harm", "code": "4", "example": "Being involved in any patient safety incident is not pleasant, but please select ‘no harm’ if you are not aware of any specific psychological harm that meets the description of ‘low psychological harm’ or worse. Pain should be recorded under physical harm rather than psychological harm.", "example_title": "What does this mean?" }, { "val": "Low psychological harm", "code": "3", "example": "Low psychological harm is when at least one of the following apply:
", "example_title": "What does this mean?" }, { "val": "Moderate psychological harm", "code": "2", "example": "Moderate psychological harm is when at least one of the following apply:
", "example_title": "What does this mean?" }, { "val": "Severe psychological harm", "code": "1", "example": "Severe psychological harm is when at least one of the following apply:
", "example_title": "What does this mean?" } ], "conditions": [ { "id": -559, "tracker": 252, "if_word": "1", "percent_match": 0, "if_email": [], "completed": false, "if_value": "2", "show_page": ["-394"], "action_type": "show_page" }, { "id": -560, "tracker": 253, "if_word": "1", "percent_match": 0, "if_email": [], "completed": false, "if_value": "1", "show_page": ["-394"], "action_type": "show_page" } ] }, "order": 3, "type": "field", "draging": false, "has_over": false, "has_input": true, "hide": false, "disable": false, "good_care": false, "always_show": false, "check_one": false, "is_label_hidden": false, "connected_involvement_field": null, "connected_involvement": null, "sub_label": "Please note that when recording psychological harm, you are not required to make a formal diagnosis; your answer should be an assessment based on the information you have at the point of recording and can be changed if further information becomes available.", "is_nhs_field": true, "nhs_extension_url": "PsychologicalHarm", "summary_label": "Patient Psychological Harm", "hide_in_summary": true } ], "order": 43, "type": "page", "draging": false, "has_over": false, "is_required": false, "allow_only_one": false, "is_required_special": false, "progress_bar_name": "OT002", "is_nhs_hidden": true, "is_nhs_page": true, "is_default_nhs_hidden": true, "is_check_your_answer_type": false, "is_event_summary_type": false, "is_patient_summary_type": false }, { "id": -386, "tracker": 128, "name": "OT003", "label": "OT003", "items": [ { "id": -388, "tracker": 129, "label": "Patient Details", "name": "Patient Details", "input": { "component": "h3", "type": "text_block", "type_label": "Heading 3", "conditions": [], "hyperlink": { "title": "Make Hyperlink ?", "value": "", "applied": false }, "font_size": 24, "text_color": "#000000" }, "order": 2, "type": "field", "draging": false, "has_over": false, "has_input": true, "hide": false, "disable": false, "good_care": false, "always_show": false, "check_one": false, "is_label_hidden": false, "connected_involvement_field": null, "connected_involvement": null, "hide_in_summary": true }, { "id": -409, "tracker": 130, "label": "How did this impact the patient and their subsequent care?", "name": "How did this impact the patient and their subsequent care?", "input": { "type": "textarea", "type_label": "Long Text", "placeholder": "", "required": true, "has_actions": true, "validation_error": "", "category": 1, "default_answer": { "title": "Default Answer", "value": "", "applied": false }, "min_characters": { "title": "Min Characters", "value": "", "applied": false }, "max_characters": { "title": "Max Characters", "value": "", "applied": false }, "conditions": [] }, "order": 3, "type": "field", "draging": false, "has_over": false, "has_input": true, "hide": false, "disable": false, "good_care": false, "always_show": false, "check_one": false, "is_label_hidden": false, "connected_involvement_field": null, "connected_involvement": null, "sub_label": "Describe any physical or psychological impact on the patient as a result of the incident, or how their care was subsequently changed as a result. Your answer should be based on the information you have at this point, and can be changed if further information becomes available.", "is_nhs_field": true, "nhs_extension_url": "ClinicalOutcome", "summary_label": "Patient Clinical Outcome", "hide_in_summary": true } ], "order": 44, "type": "page", "draging": false, "has_over": false, "is_required": false, "allow_only_one": false, "is_required_special": false, "progress_bar_name": "OT003", "is_nhs_hidden": false, "is_nhs_page": true, "is_default_nhs_hidden": false, "is_check_your_answer_type": false, "is_event_summary_type": false, "is_patient_summary_type": false }, { "id": -394, "tracker": 131, "name": "ST001", "label": "ST001", "items": [ { "id": -396, "tracker": 132, "label": "Patient Details", "name": "Patient Details", "input": { "component": "h3", "type": "text_block", "type_label": "Heading 3", "conditions": [], "hyperlink": { "title": "Make Hyperlink ?", "value": "", "applied": false }, "font_size": 24, "text_color": "#000000" }, "order": 2, "type": "field", "draging": false, "has_over": false, "has_input": true, "hide": false, "disable": false, "good_care": false, "always_show": false, "check_one": false, "is_label_hidden": false, "connected_involvement_field": null, "connected_involvement": null, "hide_in_summary": true }, { "id": -397, "tracker": 133, "label": "How much did the incident contribute to the outcome for the patient?", "name": "How much did the incident contribute to the outcome for the patient?", "input": { "type": "radio", "type_label": "Multiple choice", "placeholder": "", "required": true, "has_actions": true, "validation_error": "", "category": 2, "default_answer": { "title": "Default Selection", "value": "", "applied": false }, "options": [ { "val": "The incident caused the outcome", "code": "6" }, { "val": "The incident probably affected the outcome", "code": "5" }, { "val": "The incident possibly affected the outcome", "code": "4" }, { "val": "The incident was not related to the outcome", "code": "3" }, { "val": "I don't know", "code": "2" } ], "conditions": [] }, "order": 3, "type": "field", "draging": false, "has_over": false, "has_input": true, "hide": false, "disable": false, "good_care": false, "always_show": false, "check_one": false, "is_label_hidden": false, "connected_involvement_field": null, "connected_involvement": null, "sub_label": "Your answer should be based on your own judgement, given the information you have at this point. Your personal perspective on this is valuable. This question is being trialled by the national Patient Safety team to explore whether it can help prioritise incidents with the greatest opportunities for learning.", "is_nhs_field": true, "nhs_extension_url": "StrengthOfAssociation", "summary_label": "Incident contribute to the outcome for the patient", "hide_in_summary": true } ], "order": 45, "type": "page", "draging": false, "has_over": false, "is_required": false, "allow_only_one": false, "is_required_special": false, "progress_bar_name": "ST001", "is_nhs_hidden": true, "is_nhs_page": true, "is_default_nhs_hidden": true, "is_check_your_answer_type": false, "is_event_summary_type": false, "is_patient_summary_type": false }, { "id": -402, "tracker": 134, "name": "Patient Summary", "label": "Patient Summary", "items": [ { "id": -404, "tracker": 135, "label": "Patient Details", "name": "Patient Details", "input": { "component": "h3", "type": "text_block", "type_label": "Heading 3", "conditions": [], "hyperlink": { "title": "Make Hyperlink ?", "value": "", "applied": false }, "font_size": 24, "text_color": "#000000" }, "order": 2, "type": "field", "draging": false, "has_over": false, "has_input": true, "hide": false, "disable": false, "good_care": false, "always_show": false, "check_one": false, "is_label_hidden": false, "connected_involvement_field": null, "connected_involvement": null, "sub_label": "Please review the information below before continuing.", "hide_in_summary": true } ], "order": 46, "type": "page", "draging": false, "has_over": false, "is_required": false, "allow_only_one": false, "is_required_special": false, "progress_bar_name": "Patient Summary", "is_nhs_hidden": false, "is_nhs_page": true, "is_default_nhs_hidden": false, "is_check_your_answer_type": false, "is_event_summary_type": false, "is_patient_summary_type": true }, { "id": -65, "tracker": 136, "name": "RI003", "label": "RI003", "items": [ { "id": -67, "tracker": 137, "label": "Is there imminent risk of severe harm or death?", "name": "Is there imminent risk of severe harm or death?", "input": { "type": "radio", "type_label": "Multiple choice", "placeholder": "", "required": true, "has_actions": true, "validation_error": "", "category": 2, "default_answer": { "title": "Default Selection", "value": "", "applied": false }, "options": [ { "val": "Yes", "code": "y" }, { "val": "No", "code": "n" }, { "val": "I don't know", "code": "u" } ], "conditions": [] }, "order": 2, "type": "field", "draging": false, "has_over": false, "has_input": true, "hide": false, "disable": false, "good_care": false, "always_show": false, "check_one": false, "is_label_hidden": false, "connected_involvement_field": null, "connected_involvement": null, "sub_label": "An imminent risk is one that is likely to be a problem within weeks. Severe harm is something that is likely to make someone need life-saving care, require hospital treatment for more than 2 weeks or reduce a person’s independence for more than 6 months.", "is_nhs_field": true, "nhs_extension_url": "RiskImminent", "summary_label": "Scale of risk", "hide_in_summary": false } ], "order": 47, "type": "page", "draging": false, "has_over": false, "is_required": false, "allow_only_one": false, "is_required_special": false, "progress_bar_name": "RI003", "is_nhs_hidden": true, "is_nhs_page": true, "is_default_nhs_hidden": true, "is_check_your_answer_type": false, "is_event_summary_type": false, "is_patient_summary_type": false }, { "id": -68, "tracker": 138, "name": "RI005", "label": "RI005", "items": [ { "id": -70, "tracker": 139, "label": "Which groups of patients are at risk? (Optional)", "name": "Which groups of patients are at risk? (Optional)", "input": { "type": "textarea", "type_label": "Long Text", "placeholder": "", "required": false, "has_actions": true, "validation_error": "", "category": 1, "default_answer": { "title": "Default Answer", "value": "", "applied": false }, "min_characters": { "title": "Min Characters", "value": "", "applied": false }, "max_characters": { "title": "Max Characters", "value": "", "applied": false }, "conditions": [] }, "order": 2, "type": "field", "draging": false, "has_over": false, "has_input": true, "hide": false, "disable": false, "good_care": false, "always_show": false, "check_one": false, "is_label_hidden": false, "connected_involvement_field": null, "connected_involvement": null, "sub_label": "For example, people of a certain age, gender, location or with a certain condition or treatment.", "is_nhs_field": true, "nhs_extension_url": "RiskPopulation", "summary_label": "Patients at risk", "hide_in_summary": false } ], "order": 48, "type": "page", "draging": false, "has_over": false, "is_required": false, "allow_only_one": false, "is_required_special": false, "progress_bar_name": "RI005", "is_nhs_hidden": true, "is_nhs_page": true, "is_default_nhs_hidden": true, "is_check_your_answer_type": false, "is_event_summary_type": false, "is_patient_summary_type": false }, { "id": -72, "tracker": 140, "name": "CL007", "label": "CL007", "items": [ { "id": -74, "tracker": 141, "label": "How concerned are you about this incident and its implications?", "name": "How concerned are you about this incident and its implications?", "input": { "type": "radio", "type_label": "Multiple choice", "placeholder": "", "required": true, "has_actions": true, "validation_error": "", "category": 2, "default_answer": { "title": "Default Selection", "value": "", "applied": false }, "options": [ { "val": "Very concerned", "code": "5" }, { "val": "Fairly concerned", "code": "4" }, { "val": "Not very concerned", "code": "3" }, { "val": "Not at all concerned", "code": "1" } ], "conditions": [] }, "order": 2, "type": "field", "draging": false, "has_over": false, "has_input": true, "hide": false, "disable": false, "good_care": false, "always_show": false, "check_one": false, "is_label_hidden": false, "connected_involvement_field": null, "connected_involvement": null, "sub_label": "Indicate the impact on the safety of healthcare overall, and/or to what extent others may not be aware that this issue exists. Your answer should be based on your own judgement, given the information you have at this point, and can be changed if further information becomes available. Your personal perspective on this is valuable. This question is being trialled by the national Patient Safety team to explore whether it can help point to incidents which enable proactive national action, alongside the reactive responses to the most severe harms.
Select one.", "is_nhs_field": true, "nhs_extension_url": "LevelOfConcern", "summary_label": "Your concern", "hide_in_summary": false } ], "order": 49, "type": "page", "draging": false, "has_over": false, "is_required": false, "allow_only_one": false, "is_required_special": false, "progress_bar_name": "CL007", "is_nhs_hidden": false, "is_nhs_page": true, "is_default_nhs_hidden": false, "is_check_your_answer_type": false, "is_event_summary_type": false, "is_patient_summary_type": false }, { "id": -74, "tracker": 144, "name": "Event Summary", "label": "Event Summary", "items": [ { "id": -76, "tracker": 145, "label": "Event Detail", "name": "Event Detail", "input": { "component": "h1", "type": "text_block", "type_label": "Heading 1", "conditions": [], "hyperlink": { "title": "Make Hyperlink ?", "value": "", "applied": false }, "font_size": 34, "text_color": "#000000" }, "order": 2, "type": "field", "draging": false, "has_over": false, "has_input": true, "hide": false, "disable": false, "good_care": false, "always_show": false, "check_one": false, "is_label_hidden": false, "connected_involvement_field": null, "connected_involvement": null, "is_nhs_field": true, "hide_in_summary": true } ], "order": 51, "type": "page", "draging": false, "has_over": false, "is_required": false, "allow_only_one": false, "is_required_special": false, "progress_bar_name": "Event Summary", "is_nhs_hidden": false, "is_nhs_page": true, "is_default_nhs_hidden": false, "is_check_your_answer_type": false, "is_event_summary_type": true, "is_patient_summary_type": false }, { "id": -77, "tracker": 146, "name": "Check your answers", "label": "Check your answers", "items": [ { "id": -78, "tracker": 147, "label": "Check your answers before submitting", "name": "Check your answers before submitting", "input": { "component": "h1", "type": "text_block", "type_label": "Heading 1", "conditions": [], "hyperlink": { "title": "Make Hyperlink ?", "value": "", "applied": false }, "font_size": 34, "text_color": "#000000" }, "order": 2, "type": "field", "draging": false, "has_over": false, "has_input": true, "hide": false, "disable": false, "good_care": false, "always_show": false, "check_one": false, "is_label_hidden": false, "connected_involvement_field": null, "connected_involvement": null, "is_nhs_field": true, "hide_in_summary": true } ], "order": 50, "type": "page", "draging": false, "has_over": false, "is_required": false, "allow_only_one": false, "is_required_special": false, "progress_bar_name": "Check your answers", "is_nhs_hidden": false, "is_nhs_page": true, "is_default_nhs_hidden": false, "is_check_your_answer_type": true, "is_event_summary_type": false, "is_patient_summary_type": false }, { "id": -547, "tracker": 148, "name": "DMD001,DMD002,DMD003", "label": "DMD001,DMD002,DMD003", "items": [ { "id": -547, "tracker": 149, "label": "Which medicines were involved in what went wrong? (Optional)", "name": "Which medicines were involved in what went wrong? (Optional)", "input": { "type": "dmd", "type_label": "DM+D", "sub_type": "dmd", "placeholder": "", "required": false, "has_actions": true, "validation_error": "", "category": 3, "is_add_another_btn": true, "default_answer": { "title": "Default Selection", "value": "", "applied": false }, "multi_select": true, "remote_options": "/api/lfpse/dmd_vtm", "options": [], "vmp_options": [], "conditions": [], "value": { "vmp": { "vp_id": "", "vp_string": "" }, "vtm": { "vtm_id": "", "vtm_string": "" }, "other": "" }, "records": [] }, "order": 2, "type": "field", "draging": false, "has_over": false, "has_input": true, "hide": false, "disable": false, "good_care": false, "always_show": false, "check_one": false, "is_label_hidden": false, "connected_involvement_field": null, "connected_involvement": null, "is_nhs_field": true, "nhs_extension_url": "medication", "hide_in_summary": false } ], "order": 4, "type": "page", "draging": false, "has_over": false, "is_required": false, "allow_only_one": false, "is_required_special": false, "progress_bar_name": "DMD001,DMD002,DMD003", "is_nhs_hidden": true, "is_default_nhs_hidden": true, "is_check_your_answer_type": false, "is_event_summary_type": false, "is_patient_summary_type": false }, { "id": -1343, "tracker": 150, "name": "T001G", "label": "T001G", "items": [ { "id": -1331, "tracker": 151, "label": "Did this happen today?", "name": "Did this happen today?", "input": { "type": "radio", "type_label": "Multiple choice", "placeholder": "", "required": true, "has_actions": true, "validation_error": "", "category": 2, "is_display_case": false, "is_display_summary": false, "default_answer": { "title": "Default Selection", "value": "", "applied": false }, "options": [ { "val": "Yes", "code": "y" }, { "val": "No", "code": "n" }, { "val": "I don't know", "code": "u" } ], "conditions": [ { "id": -1598, "tracker": 270, "if_word": "1", "percent_match": 0, "if_email": [], "completed": false, "if_value": "n", "show_page": ["-1460"], 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(Optional)", "order": 2, "draging": false, "tracker": 106, "has_over": false, "has_input": true } ], "order": 23, "draging": false, "tracker": 104, "has_over": false, "is_nhs_field": true, "is_nhs_hidden": false, "summary_label": "Do you think this incident involved any of these problems with medicines or medical devices?", "hide_in_summary": false, "nhs_extension_url": "DrugReaction" }, { "id": -112, "name": "A011", "type": "page", "items": [ { "id": -114, "hide": false, "type": "field", "input": { "type": "radio", "options": [ { "val": "Yes", "code": "y" }, { "val": "No", "code": "n" }, { "val": "I don't know", "code": "u" } ], "category": 2, "required": false, "conditions": [], "type_label": "Multiple choice", "has_actions": true, "placeholder": "", "default_answer": { "title": "Default Selection", "value": "", "applied": false }, "is_display_case": false, "validation_error": "", "is_display_summary": false }, "label": "Was a device used to give medication in this instance? (Optional)", "order": 2, "draging": false, "tracker": 114, "has_over": false, "has_input": true, "is_nhs_field": true, "summary_label": "Was a device used to give medication in this instance?", "hide_in_summary": false, "nhs_extension_url": "MedicationAdministration" } ], "order": 24, "draging": false, "tracker": 112, "has_over": false, "is_nhs_page": true, "is_nhs_hidden": false, "is_default_nhs_hidden": false, "is_event_summary_type": false, "is_patient_summary_type": false, "is_check_your_answer_type": false }, { "id": -117, "name": "MDT 4", "type": "page", "items": [ { "id": -119, "hide": false, "type": "field", "input": { "type": "checkbox", "value": [], "options": [ { "val": "The device was used when it should not have been", "code": "1" }, { "val": "The device was not used when it should have been", "code": "2" }, { "val": "The device was used incorrectly", "code": "3" }, { "val": "The device was available but broken, not fit for use or didn't perform as expected", "code": "4" }, { "val": "The device was involved in an accident, trip or collision", "code": "5" }, { "val": "Other", "code": "6" }, { "val": "I don't know", "code": "7" } ], "category": 2, "required": false, "conditions": [ { "id": -2389, "tracker": 338, "if_value": "1", "show_page": ["-2181"], "action_type": "show_page" }, { "id": -2390, "tracker": 339, "if_value": "2", "show_page": ["-2152"], "action_type": "show_page" }, { "id": -2392, "tracker": 341, "if_value": "3", "show_page": ["-2167"], "action_type": "show_page" }, { "id": -2393, "tracker": 342, "if_value": "4", "show_page": ["-2180"], "action_type": "show_page" }, { "id": -2395, "tracker": 344, "if_value": "6", "show_page": ["-2221"], "action_type": "show_page" } ], "type_label": "Checkbox", "has_actions": true, "placeholder": "", "default_answer": { "title": "Default Selections", "value": "", "applied": false }, "has_none_option": true, "validation_error": "" }, "label": "How was the device involved in what went wrong? (Optional)", "order": 2, "draging": false, "tracker": 326, "has_over": false, "has_input": true, "sub_label": "Select all that apply", "is_nhs_field": true, "summary_label": "How was the device involved in what went wrong?", "hide_in_summary": false, "nhs_extension_url": "DeviceInvolvementFactors", "connected_involvement": null, "connected_involvement_field": null } ], "order": 25, "draging": false, "tracker": 325, "has_over": false, "is_nhs_page": true, "is_nhs_hidden": false, "is_default_nhs_hidden": false, "is_event_summary_type": false, "is_patient_summary_type": false, "is_check_your_answer_type": false }, { "id": -2152, "name": "PB035", "type": "page", "items": [ { "id": -2154, "hide": false, "type": "field", "input": { "type": "checkbox", "value": [], "options": [ { "val": "Too few devices were used", "code": "1" }, { "val": "There was a delay in using the device", "code": "2" }, { "val": "The devices was not used for long enough", "code": "3" }, { "val": "The device was not available", "code": "4" }, { "val": "The device was underused or used on too low a setting", "code": "5" } ], "category": 2, "required": false, "conditions": [], "type_label": "Checkbox", "has_actions": true, "placeholder": "", "default_answer": { "title": "Default Selections", "value": "", "applied": false }, "is_display_case": false, "validation_error": "", "is_display_summary": false }, "label": "How was the device not used when it should have been?(Optional)", "order": 2, "draging": false, "tracker": 328, "has_over": false, "has_input": true, "sub_label": "Select all that apply", "is_nhs_field": true, "summary_label": "How was the device not used when it should have been?", "hide_in_summary": false, "nhs_extension_url": "DeviceInsufficientDetails" } ], "order": 27, "draging": false, "tracker": 327, "has_over": false, "is_nhs_page": true, "is_nhs_hidden": true, "is_default_nhs_hidden": true, "is_event_summary_type": false, "is_patient_summary_type": false, "is_check_your_answer_type": false }, { "id": -2167, "name": "PB041", "type": "page", "items": [ { "id": -2169, "hide": false, "type": "field", "input": { "type": "checkbox", "value": [], "options": [ { "val": "The wrong device was used instead of the correct device", "code": "1" }, { "val": "The wrong device was used alongside the correct device", "code": "2" }, { "val": "Only part of the correct device was used", "code": "3" }, { "val": "The device was used off-license or for an unintended purpose", "code": "4" }, { "val": "The device was not used as per instructions for use or was set up incorrectly", "code": "5" } ], "category": 2, "required": true, "conditions": [], "type_label": "Checkbox", "has_actions": true, "placeholder": "", "default_answer": { "title": "Default Selections", "value": "", "applied": false }, "is_display_case": false, "validation_error": "", "is_display_summary": false }, "label": "How was the device used incorrectly? (Optional)", "order": 2, "draging": false, "tracker": 330, "has_over": false, "has_input": true, "sub_label": "Select all that apply", "is_nhs_field": true, "summary_label": "How was the device used incorrectly?", "hide_in_summary": false, "nhs_extension_url": "DeviceWrongUsageDetails" } ], "order": 28, "draging": false, "tracker": 329, "has_over": false, "is_nhs_page": true, "is_nhs_hidden": true, "is_default_nhs_hidden": true, "is_event_summary_type": false, "is_patient_summary_type": false, "is_check_your_answer_type": false }, { "id": -2180, "name": "PB051", "type": "page", "items": [ { "id": -2198, "hide": false, "type": "field", "input": { "type": "checkbox", "value": [], "options": [ { "val": "The packaging was damaged making it unfit for use", "code": "1" }, { "val": "The device was broken or damaged before use", "code": "2" }, { "val": "The device broke or was damaged in use", "code": "3" }, { "val": "The device was dirty or unsterile", "code": "4" }, { "val": "The device was not stored correctly", "code": "5" }, { "val": "The device was out of date", "code": "6" }, { "val": "There was no power supply for the device/the battery was not charged/the device ran out of power during use", "code": "7" }, { "val": "The device had no connectivity/wifi connection", "code": "8" }, { "val": "The device was used as per guidance but did not perform as expected and/or caused unexpected consequences", "code": "9" }, { "val": "There were no component parts/consumables available that must be used with the device", "code": "10" } ], "category": 2, "required": false, "conditions": [], "type_label": "Checkbox", "has_actions": true, "placeholder": "", "default_answer": { "title": "Default Selections", "value": "", "applied": false }, "is_display_case": false, "validation_error": "", "is_display_summary": false }, "label": "What was wrong with the device? (Optional)", "order": 2, "draging": false, "tracker": 332, "has_over": false, "has_input": true, "sub_label": "Select all that apply", "is_nhs_field": true, "summary_label": "What was wrong with the device?", "hide_in_summary": false, "nhs_extension_url": "DeviceBrokenDetails" } ], "order": 29, "draging": false, "tracker": 331, "has_over": false, "is_nhs_page": true, "is_nhs_hidden": true, "is_default_nhs_hidden": true, "is_event_summary_type": false, "is_patient_summary_type": false, "is_check_your_answer_type": false }, { "id": -2181, "name": "PB029", "type": "page", "items": [ { "id": -2183, "hide": false, "type": "field", "input": { "type": "checkbox", "value": [], "options": [ { "val": "The device was used when it should not have been", "code": "1" }, { "val": "The device was used too soon", "code": "2" }, { "val": "The device was used for too long", "code": "3" }, { "val": "The device was accidentally retained", "code": "4" }, { "val": "The device was overused or used on too high a setting", "code": "5" } ], "category": 2, "required": false, "conditions": [], "type_label": "Checkbox", "has_actions": true, "placeholder": "", "default_answer": { "title": "Default Selections", "value": "", "applied": false }, "is_display_case": false, "validation_error": "", "is_display_summary": false }, "label": "How was the device used when it should not have been? (Optional)", "order": 2, "draging": false, "tracker": 334, "has_over": false, "has_input": true, "sub_label": "Select all that apply", "is_nhs_field": true, "summary_label": "How was the device used when it should not have been?", "hide_in_summary": false, "nhs_extension_url": "DeviceUsedUnnecessarily" } ], "order": 26, "draging": false, "tracker": 333, "has_over": false, "is_nhs_page": true, "is_nhs_hidden": true, "is_default_nhs_hidden": true, "is_event_summary_type": false, "is_patient_summary_type": false, "is_check_your_answer_type": false }, { "id": -2221, "name": "PB057", "type": "page", "items": [ { "id": -2223, "hide": false, "type": "field", "input": { "type": "textarea", "category": 1, "required": false, "conditions": [], "type_label": "Long Text", "has_actions": true, "placeholder": "", "default_answer": { "title": "Default Answer", "value": "", "applied": false }, "max_characters": { "title": "Max Characters", "value": "", "applied": false }, "min_characters": { "title": "Min Characters", "value": "", "applied": false }, "is_display_case": false, "validation_error": "", "is_display_summary": false }, "label": "What was the problem with devices?", "order": 2, "draging": false, "tracker": 336, "has_over": false, "has_input": true, "is_nhs_field": true, "summary_label": "What was the problem with devices?", "hide_in_summary": false, "nhs_extension_url": "ProblemDescriptionDevices" } ], "order": 30, "draging": false, "tracker": 335, "has_over": false, "is_nhs_page": true, "is_nhs_hidden": true, "is_default_nhs_hidden": true, "is_event_summary_type": false, "is_patient_summary_type": false, "is_check_your_answer_type": false } ], "title": "Medical Devices details", "complete": false }, "4": { "id": 4, "pages": [ { "id": -2148, "name": "PB068", "type": "page", "items": [ { "id": -2151, "hide": false, "type": "field", "input": { "type": "checkbox", "value": [], "options": [ { "val": "Prescribing", "code": "1" }, { "val": "Dispensing", "code": "2" }, { "val": "Administration", "code": "3" }, { "val": "Advice relating to medicines use", "code": "6" }, { "val": "Supply from a clinical area", "code": "7" }, { "val": "Security and storage", "code": "8" }, { "val": "Other", "code": "4" }, { "val": "I don't know", "code": "5" } ], "category": 2, "required": false, "conditions": [ { "id": -4006, "tracker": 364, "if_value": "4", "action_type": "show_question", "show_question": ["-3993"] } ], "type_label": "Checkbox", "has_actions": true, "placeholder": "", "default_answer": { "title": "Default Selections", "value": "", "applied": false }, "has_none_option": true, "is_display_case": false, "validation_error": "", "is_display_summary": false }, "label": "Which of the following medication processes were involved in what went wrong?(optional)", "sub_label": "Select all that apply.", "order": 2, "draging": false, "tracker": 332, "has_over": false, "has_input": true, "is_nhs_field": true, "summary_label": "Which of the following medication processes were involved in what went wrong?", "has_none_option": true, "hide_in_summary": false, "nhs_extension_url": "InvolvedProcesses" }, { "id": -3993, "hide": true, "type": "field", "input": { "type": "text", "category": 1, "required": false, "conditions": [], "type_label": "Short Text", "has_actions": true, "placeholder": "", "default_answer": { "title": "Default Answer", "value": "", "applied": false }, "max_characters": { "title": "Max Characters", "value": "", "applied": false }, "min_characters": { "title": "Min Characters", "value": "", "applied": false }, "is_display_case": false, "validation_error": "", "is_display_summary": false }, "label": "Please specify", "order": 2, "disable": false, "draging": false, "tracker": 351, "has_over": false, "good_care": false, "has_input": true, "always_show": false, "is_nhs_field": true, "summary_label": "Which of the following medication processes were involved in what went wrong? Other", "hide_in_summary": false, "nhs_extension_url": "InvolvedProcessesOther", "connected_involvement": null, "connected_involvement_field": null } ], "order": 50, "draging": false, "tracker": 331, "has_over": false, "is_nhs_page": true, "is_nhs_hidden": false, "is_default_nhs_hidden": false, "is_event_summary_type": false, "is_patient_summary_type": false, "is_check_your_answer_type": false }, { "id": -2172, "name": "PB002", "type": "page", "items": [ { "id": -2174, "hide": false, "type": "field", "input": { "type": "checkbox", "value": [], "options": [ { "val": "Side effects (also known as Adverse Drug Reactions or ADRs)", "code": "1" }, { "val": "Defective or counterfeit medicines", "code": "2" }, { "val": "Defective or counterfeit medical devices", "code": "3" }, { "val": "Poor packaging or design of medicines that might lead to errors", "code": "4" }, { "val": "Poor packaging or design of medical devices that might lead to errors", "code": "5" }, { "val": "I don't know", "code": "7", "also_none": true }, { "val": "None of the above", "code": "6" } ], "category": 2, "required": false, "conditions": [], "type_label": "Checkbox", "has_actions": true, "placeholder": "", "default_answer": { "title": "Default Selections", "value": "", "applied": false }, "has_none_option": true, "is_display_case": false, "validation_error": "", "is_display_summary": false }, "label": "Do you think this incident involved any of these problems with medicines or medical devices? (Optional)", "order": 2, "draging": false, "tracker": 334, "has_over": false, "has_input": true, "is_nhs_field": true, "summary_label": "Do you think this incident involved any of these problems with medicines or medical devices?", "hide_in_summary": false, "nhs_extension_url": "DrugReaction" } ], "order": 51, "draging": false, "tracker": 333, "has_over": false, "is_nhs_page": true, "is_nhs_hidden": false, "is_default_nhs_hidden": false, "is_event_summary_type": false, "is_patient_summary_type": false, "is_check_your_answer_type": false }, { "id": -2202, "name": "A011", "type": "page", "items": [ { "id": -2205, "hide": false, "type": "field", "input": { "type": "radio", "options": [ { "val": "Yes", "code": "y" }, { "val": "No", "code": "n" }, { "val": "I don't know", "code": "u" } ], "category": 2, "required": false, "conditions": [], "type_label": "Multiple choice", "has_actions": true, "placeholder": "", "default_answer": { "title": "Default Selection", "value": "", "applied": false }, "is_display_case": false, "validation_error": "", "is_display_summary": false }, "label": "Was a device used to give medication in this instance? (Optional)", "order": 2, "draging": false, "tracker": 336, "has_over": false, "has_input": true, "is_nhs_field": true, "summary_label": "Was a device used to give medication in this instance?", "hide_in_summary": false, "nhs_extension_url": "MedicationAdministration" } ], "order": 52, "draging": false, "tracker": 335, "has_over": false, "is_nhs_page": true, "is_nhs_hidden": false, "is_default_nhs_hidden": false, "is_event_summary_type": false, "is_patient_summary_type": false, "is_check_your_answer_type": false }, { "id": -2215, "name": "PB022", "type": "page", "items": [ { "id": -2217, "hide": false, "type": "field", "input": { "type": "checkbox", "options": [ { "val": "Too much medication was prescribed/dispensed/administered", "code": "1" }, { "val": "Too little medication was prescribed/dispensed/administered", "code": "2" }, { "val": "The medication was prescribed/dispensed/administered incorrectly", "code": "3" }, { "val": "Something was wrong with the medication and/or it's packaging", "code": "4" }, { "val": "Other", "code": "5" }, { "val": "I don't know", "code": "6" } ], "category": 2, "required": false, "conditions": [ { "id": -2464, "tracker": 350, "if_value": "1", "show_page": ["-2230"], "action_type": "show_page" }, { "id": -2465, "tracker": 351, "if_value": "2", "show_page": ["-2245"], "action_type": "show_page" }, { "id": -2466, "tracker": 352, "if_value": "3", "show_page": ["-2262"], "action_type": "show_page" }, { "id": -2467, "tracker": 353, "if_value": "4", "show_page": ["-2281"], "action_type": "show_page" }, { "id": -2468, "tracker": 354, "if_value": "5", "show_page": ["-2290"], "action_type": "show_page" } ], "type_label": "Checkbox", "has_actions": true, "placeholder": "", "default_answer": { "title": "Default Selection", "value": "", "applied": false }, "has_none_option": true, "is_display_case": false, "validation_error": "", "is_display_summary": false }, "label": "How was medication involved in what went wrong? (Optional)", "order": 2, "draging": false, "tracker": 338, "has_over": false, "has_input": true, "sub_label": "Select all that apply", "is_nhs_field": true, "summary_label": "How was medication involved in what went wrong?", "hide_in_summary": false, "nhs_extension_url": "DrugInvolvementFactors", "connected_involvement": null, "connected_involvement_field": null } ], "order": 53, "draging": false, "tracker": 337, "has_over": false, "is_nhs_page": true, "is_nhs_hidden": false, "is_default_nhs_hidden": false, "is_event_summary_type": false, "is_patient_summary_type": false, "is_check_your_answer_type": false }, { "id": -2230, "name": "PB030", "type": "page", "items": [ { "id": -2232, "hide": false, "type": "field", "input": { "type": "checkbox", "options": [ { "val": "The prescribed/dispensed/administered dosage was too high", "code": "1" }, { "val": "The medication was prescribed/dispensed/administered too early", "code": "2" }, { "val": "The medication was prescribed/dispensed/administered for too long a duration", "code": "3" }, { "val": "The medication was prescribed/dispensed/administered at too fast a rate", "code": "4" }, { "val": "The medication was prescribed/dispensed/administered too frequently", "code": "5" }, { "val": "The medication was prescribed/dispensed/administered when it should not have been", "code": "6" } ], "category": 2, "required": false, "conditions": [], "type_label": "Checkbox", "has_actions": true, "placeholder": "", "default_answer": { "title": "Default Selection", "value": "", "applied": false }, "is_display_case": false, "validation_error": "", "is_display_summary": false }, "label": "How was too much medication prescribed/dispensed/administered? (Optional)", "order": 2, "draging": false, "tracker": 340, "has_over": false, "has_input": true, "sub_label": "Select all that apply", "is_nhs_field": true, "summary_label": "How was too much medication prescribed/dispensed/administered?", "hide_in_summary": false, "nhs_extension_url": "DrugUsedTooMuch" } ], "order": 54, "draging": false, "tracker": 339, "has_over": false, "is_nhs_page": true, "is_nhs_hidden": true, "is_default_nhs_hidden": true, "is_event_summary_type": false, "is_patient_summary_type": false, "is_check_your_answer_type": false }, { "id": -2245, "name": "PB036", "type": "page", "items": [ { "id": -2247, "hide": false, "type": "field", "input": { "type": "checkbox", "options": [ { "val": "The prescribed/dispensed/administered dosage was too low", "code": "1" }, { "val": "The medication was prescribed/dispensed/administered too late", "code": "2" }, { "val": "The medication was prescribed/dispensed/administered for too short a duration", "code": "3" }, { "val": "The medication was prescribed/dispensed/administered at too slow a rate", "code": "4" }, { "val": "The medication was not prescribed/dispensed/administered frequently enough", "code": "5" }, { "val": "The prescribed/dispensed/administered medication was omitted", "code": "6" } ], "category": 2, "required": false, "conditions": [], "type_label": "Checkbox", "has_actions": true, "placeholder": "", "default_answer": { "title": "Default Selection", "value": "", "applied": false }, "is_display_case": false, "validation_error": "", "is_display_summary": false }, "label": "How was too little medication prescribed/dispensed/administered? 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{ "val": "Too great a quantity or number of tissues or organs for transplant were used", "code": "1" }, { "val": "Tissues or organs for transplant were used when they were not required", "code": "2" }, { "val": "Tissues or organs for transplant were used too soon", "code": "3" } ], "category": 2, "required": false, "conditions": [], "type_label": "Checkbox", "has_actions": true, "placeholder": "", "default_answer": { "title": "Default Selections", "value": "", "applied": false }, "is_display_case": false, "validation_error": "", "is_display_summary": false }, "label": "How were too much/many tissues or organs for transplant used?", "order": 2, "draging": false, "tracker": 446, "has_over": false, "has_input": true, "sub_label": "Select all that apply", "is_nhs_field": true, "summary_label": "How were too much/many tissues or organs for transplant used?", "hide_in_summary": false, "nhs_extension_url": "TissueOrgansUsedTooMuch" } ], "order": 102, "draging": false, "tracker": 445, 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"sub_label": "Select all that apply", "is_nhs_field": true, "summary_label": "How were too few/little tissues or organs for transplant used?", "hide_in_summary": false, "nhs_extension_url": "TissueOrgansInsufficientDetails" } ], "order": 103, "draging": false, "tracker": 447, "has_over": false, "is_nhs_page": true, "is_nhs_hidden": true, "is_default_nhs_hidden": true, "is_event_summary_type": false, "is_patient_summary_type": false, "is_check_your_answer_type": false }, { "id": -2682, "name": "PB046", "type": "page", "items": [ { "id": -2722, "hide": false, "type": "field", "input": { "type": "checkbox", "value": [], "options": [ { "val": "The wrong tissues or organs for transplant were used instead of the correct ones", "code": "1" }, { "val": "The wrong tissues or organs for transplant were used alongside the correct ones", "code": "2" }, { "val": "Only part of the correct tissues or organs for transplant were used", "code": "3" }, { "val": "Tissues or organs for transplant were used for an unintended purpose", "code": "4" }, { "val": "Tissues or organs for transplant were not used as per instructions for use", "code": "5" } ], "category": 2, "required": false, "conditions": [], "type_label": "Checkbox", "has_actions": true, "placeholder": "", "default_answer": { "title": "Default Selections", "value": "", "applied": false }, "is_display_case": false, "validation_error": "", "is_display_summary": false }, "label": "How were the wrong tissues or organs for transplant used?", "order": 2, "draging": false, "tracker": 450, "has_over": false, "has_input": true, "sub_label": "Select all that apply", "is_nhs_field": true, "summary_label": "How were the wrong tissues or organs for transplant used?", "hide_in_summary": false, "nhs_extension_url": "TissueOrgansWrongDetails" } ], "order": 104, "draging": false, "tracker": 449, "has_over": false, "is_nhs_page": true, "is_nhs_hidden": true, "is_default_nhs_hidden": true, "is_event_summary_type": false, "is_patient_summary_type": false, "is_check_your_answer_type": false }, { "id": -2683, "name": "PB066", "type": "page", "items": [ { "id": -2736, "hide": false, "type": "field", "input": { "type": "checkbox", "value": [], "options": [ { "val": "The required tissues or organs for transplant were not available", "code": "1" }, { "val": "The need for tissues or organs for transplant was not identified", "code": "2" } ], "category": 2, "required": false, "conditions": [], "type_label": "Checkbox", "has_actions": true, "placeholder": "", "default_answer": { "title": "Default Selections", "value": "", "applied": false }, "is_display_case": false, "validation_error": "", "is_display_summary": false }, "label": "Why were tissues or organs for transplant not used when they should have been?", "order": 2, "draging": false, "tracker": 452, "has_over": false, "has_input": true, "sub_label": "Select all that apply", "is_nhs_field": true, "summary_label": "Why were tissues or organs for transplant not used when they should have been?", "hide_in_summary": false, "nhs_extension_url": "TissueOrgansNotUsed" } ], "order": 105, "draging": false, "tracker": 451, "has_over": false, "is_nhs_page": true, "is_nhs_hidden": true, "is_default_nhs_hidden": true, "is_event_summary_type": false, "is_patient_summary_type": false, "is_check_your_answer_type": false }, { "id": -2684, "name": "PB054", "type": "page", "items": [ { "id": -2744, "hide": false, "type": "field", "input": { "type": "checkbox", "value": [], "options": [ { "val": "The packaging/label was damaged/unclear making them unfit for use", "code": "1" }, { "val": "The tissues or organs for transplant were contaminated", "code": "2" }, { "val": "The tissues or organs for transplant had not been not stored correctly", "code": "3" }, { "val": "The tissues or organs for transplant were damaged or of unusable quality", "code": "4" }, { "val": "The tissues or organs for transplant were used as per guidance but did not perform as expected", "code": "5" }, { "val": "There were no consumables available that were required to transplant tissues or organs", "code": "6" } ], "category": 2, "required": false, "conditions": [], "type_label": "Checkbox", "has_actions": true, "placeholder": "", "default_answer": { "title": "Default Selections", "value": "", "applied": false }, "is_display_case": false, "validation_error": "", "is_display_summary": false }, "label": "How were tissues or organs for transplant available but damaged or unfit for use?", "order": 2, "draging": false, "tracker": 454, "has_over": false, "has_input": true, "sub_label": "Select all that apply", "is_nhs_field": true, "summary_label": "How were tissues or organs for transplant available but damaged or unfit for use?", "hide_in_summary": false, "nhs_extension_url": "TissuesOrgansDamagedDetails" } ], "order": 106, "draging": false, "tracker": 453, "has_over": false, "is_nhs_page": true, "is_nhs_hidden": true, "is_default_nhs_hidden": true, "is_event_summary_type": false, "is_patient_summary_type": false, "is_check_your_answer_type": false }, { "id": -2685, "name": "PB062", "type": "page", "items": [ { "id": -2765, "hide": false, "type": "field", "input": { "type": "textarea", "category": 1, "required": false, "conditions": [], "type_label": "Long Text", "has_actions": true, "placeholder": "", "default_answer": { "title": "Default Answer", "value": "", "applied": false }, "max_characters": { "title": "Max Characters", "value": "", "applied": false }, "min_characters": { "title": "Min Characters", "value": "", "applied": false }, "is_display_case": false, "validation_error": "", "is_display_summary": false }, "label": "What was the problem with tissues or organs for transplant?", "order": 2, "draging": false, "tracker": 456, "has_over": false, "has_input": true, "is_nhs_field": true, "summary_label": "What was the problem with tissues or organs for transplant?", "hide_in_summary": false, "nhs_extension_url": "ProblemDescriptionTissuesOrgans" } ], "order": 107, "draging": false, "tracker": 455, "has_over": false, "is_nhs_page": true, "is_nhs_hidden": true, "is_default_nhs_hidden": true, "is_event_summary_type": false, "is_patient_summary_type": false, "is_check_your_answer_type": false } ], "title": "Details of tissues or organs for transplant", "complete": false }, "9": { "id": 9, "pages": [ { "id": -2148, "name": "PB093", "type": "page", "items": [ { "id": -2152, "hide": false, "type": "field", "input": { "type": "textarea", "category": 1, "required": false, "conditions": [], "type_label": "Long Text", "has_actions": true, "placeholder": "", "default_answer": { "title": "Default Answer", "value": "", "applied": false }, "max_characters": { "title": "Max Characters", "value": "", "applied": false }, "min_characters": { "title": "Min Characters", "value": "", "applied": false }, "is_display_case": false, "validation_error": "", "is_display_summary": false }, "label": "What kind of IT system 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"is_default_nhs_hidden": true, "is_event_summary_type": false, "is_patient_summary_type": false, "is_check_your_answer_type": false } ], "title": "Buildings or infrastructure details", "complete": false }, "14": { "id": 14, "pages": [ { "id": -2237, "name": "A017", "type": "page", "items": [ { "id": -2239, "hide": false, "type": "field", "input": { "type": "checkbox", "value": [], "options": [ { "val": "Infection control relating to the built environment", "code": "1" }, { "val": "Hospital food services", "code": "2" }, { "val": "Cleaning and cleanliness", "code": "3" }, { "val": "Linen and laundry services", "code": "4" }, { "val": "Pest control", "code": "5" }, { "val": "Decontamination of surgical instruments", "code": "6" }, { "val": "Healthcare waste management", "code": "7" }, { "val": "Non-emergency patient transport", "code": "8" }, { "val": "Other", "code": "9" } ], "category": 2, "required": false, "conditions": [ { "id": -2427, "tracker": 342, "if_value": "9", "action_type": 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(Optional)", "order": 2, "draging": false, "tracker": 397, "has_over": false, "has_input": true, "sub_label": "Select all that apply", "is_nhs_field": true, "summary_label": "Which of the following estates services were involved?", "hide_in_summary": false, "nhs_extension_url": "EstatesServices" }, { "id": -2259, "hide": true, "type": "field", "input": { "type": "text", "category": 1, "required": false, "conditions": [], "type_label": "Short Text", "has_actions": true, "placeholder": "", "default_answer": { "title": "Default Answer", "value": "", "applied": false }, "max_characters": { "title": "Max Characters", "value": "", "applied": false }, "min_characters": { "title": "Min Characters", "value": "", "applied": false }, "is_display_case": false, "validation_error": "", "is_display_summary": false }, "label": "Please specify", "order": 3, "draging": false, "tracker": 399, "has_over": false, "has_input": true, "is_nhs_field": true, "summary_label": "Which of the following estates services were involved? 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"is_check_your_answer_type": false }, { "id": -2472, "name": "PB078", "type": "page", "items": [ { "id": -2474, "hide": false, "type": "field", "input": { "type": "textarea", "category": 1, "required": false, "conditions": [], "type_label": "Long Text", "has_actions": true, "placeholder": "", "default_answer": { "title": "Default Answer", "value": "", "applied": false }, "max_characters": { "title": "Max Characters", "value": "", "applied": false }, "min_characters": { "title": "Min Characters", "value": "", "applied": false }, "is_display_case": false, "validation_error": "", "is_display_summary": false }, "label": "What was the problem with estates services?", "order": 2, "draging": false, "tracker": 407, "has_over": false, "has_input": true, "is_nhs_field": true, "summary_label": "What was the problem with estates services?", "hide_in_summary": false, "nhs_extension_url": "EstatesServicesProblem" } ], "order": 78, "draging": false, "tracker": 406, "has_over": false, "is_nhs_page": true, "is_nhs_hidden": true, "is_default_nhs_hidden": true, "is_event_summary_type": false, "is_patient_summary_type": false, "is_check_your_answer_type": false } ], "title": "Estates services details", "complete": false }, "20": { "id": 20, "pages": [ { "id": -3985, "name": "PB023", "type": "page", "items": [ { "id": -3987, "hide": false, "type": "field", "input": { "type": "radio", "options": [ { "val": "Yes", "code": "y" }, { "val": "No", "code": "n" } ], "category": 2, "required": true, "conditions": [ { "id": -4198, "tracker": 362, "if_value": "y", "show_page": ["-3993"], "action_type": "show_page" } ], "type_label": "Multiple choice", "has_actions": true, "placeholder": "", "default_answer": { "title": "Default Selection", "value": "", "applied": false }, "is_display_case": false, "validation_error": "", "is_display_summary": false }, "label": "Was the availability of staff a factor in this incident?", "order": 2, "disable": false, "draging": false, "tracker": 354, "has_over": false, "check_one": false, "good_care": false, "has_input": true, "always_show": false, "is_nhs_field": true, "summary_label": "Was the availability of staff a factor in this incident?", "hide_in_summary": false, "nhs_extension_url": "StaffAvailabilityIncidentFactor", "connected_involvement": null, "connected_involvement_field": null } ], "order": 53, "draging": false, "tracker": 353, "has_over": false, "is_nhs_page": true, "is_required": false, "is_nhs_hidden": false, "allow_only_one": false, "is_required_special": false, "is_default_nhs_hidden": false, "is_event_summary_type": false, "is_patient_summary_type": false, "is_check_your_answer_type": false }, { "id": -3993, "name": "PB019", "type": "page", "items": [ { "id": -3995, "hide": false, "type": "field", "input": { "type": "checkbox", "value": [], "options": [ { "val": "Too many staff involved", "code": "1" }, { "val": "Required staff not present", "code": "2" }, { "val": "Wrong skill mix", "code": "3" }, { "val": "Other", 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(Optional)", "order": 2, "disable": false, "draging": false, "tracker": 360, "has_over": false, "check_one": false, "good_care": false, "has_input": true, "always_show": false, "is_nhs_field": "true", "summary_label": "What was the problem with staff involvement or availability?", "hide_in_summary": false, "nhs_extension_url": "ProblemDescriptionInvolvement" } ], "order": 56, "draging": false, "tracker": 359, "has_over": false, "is_nhs_page": true, "is_required": false, "is_nhs_hidden": true, "allow_only_one": false, "is_required_special": false, "is_default_nhs_hidden": true, "is_event_summary_type": false, "is_patient_summary_type": false, "is_check_your_answer_type": false }, { "id": -4203, "name": "PB009", "type": "page", "items": [ { "id": -4205, "hide": false, "type": "field", "input": { "type": "radio", "value": [], "options": [ { "val": "Proactive risk assessment during service design or redesign", "code": "1" }, { "val": "At pre-admission patient assessment", "code": "2" }, { "val": "Immediately prior to care or treatment", "code": "3" }, { "val": "During direct care or treatment", "code": "4" }, { "val": "During continued care by third party agency", "code": "5" }, { "val": "After care or treatment has ended", "code": "6" }, { "val": "Other", "code": "8" }, { "val": "I don't know", "code": "7" } ], "category": 2, "required": false, "conditions": [ { "id": -4233, "tracker": 397, "if_value": "8", "action_type": "show_question", "show_question": ["-4225"] } ], "type_label": "Multiple choice", "has_actions": true, "placeholder": "", "default_answer": { "title": "Default Selections", "value": "", "applied": false }, "has_none_option": true, "is_display_case": false, "validation_error": "", "is_display_summary": false }, "label": "At what point was the incident detected? 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