Nasa Form F6 - Patient Safety Reporting System (Psrs) Report Form - California Page 3

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EVENT DESCRIPTION, continued...
Not for Patient Use
CHAIN OF EVENTS
HUMAN PERFORMANCE FACTORS
• How the problem arose
• Contributing factors
• Perceptions, judgments, decisions
• Actions or inactions
• How it was discovered
• Corrective actions
• Factors affecting the quality of human performance
PSRS / NASA Form F6, November 20
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