Locate a Fall Risk in the Hospital: _____________ Risk factors at home: Tripping over pets Grab bars are available in the bathrooms Risk factors: Slick or wet floors Make sure patients have their call lights within reach Risk factors: Loose cords that patients can trip over Identify a Risk factors related Patient history of falls Staff to be present when patient is in the bathroom (after anesthesia) Use wheelchairs for unsteady patients Fall assessment completed by PAT Have PT provide walker training for total knees Make sure crutches are fit properly to patient Provide crutch training as needed Risk factors: Patient has a visual impairment Make sure pediatric beds have padded siderails Risk factors: Patient on multiple medications Name a Risk Factor: _____________ Risk factors: Patient uses assistive devices (cane, walker, etc.) Use gait belt as needed Use of siderails on patient bed Risk factors at home: Tripping on loose rugs Use safety belts in the OR Patients should wear non- slip socks Use Fall Risk wristbands for high risk patients Locate a Fall Risk in the Hospital: _____________ Risk factors at home: Tripping over pets Grab bars are available in the bathrooms Risk factors: Slick or wet floors Make sure patients have their call lights within reach Risk factors: Loose cords that patients can trip over Identify a Risk factors related Patient history of falls Staff to be present when patient is in the bathroom (after anesthesia) Use wheelchairs for unsteady patients Fall assessment completed by PAT Have PT provide walker training for total knees Make sure crutches are fit properly to patient Provide crutch training as needed Risk factors: Patient has a visual impairment Make sure pediatric beds have padded siderails Risk factors: Patient on multiple medications Name a Risk Factor: _____________ Risk factors: Patient uses assistive devices (cane, walker, etc.) Use gait belt as needed Use of siderails on patient bed Risk factors at home: Tripping on loose rugs Use safety belts in the OR Patients should wear non- slip socks Use Fall Risk wristbands for high risk patients
(Print)
I-Locate a Fall Risk in the Hospital:
_____________
O-Risk factors at home: Tripping over pets
G-Grab bars are available in the bathrooms
B-Risk factors: Slick or wet floors
O-Make sure patients have their call lights within reach
N-Risk factors: Loose cords that patients can trip over
I-Identify a Risk factors related Patient history of falls
B-Staff to be present when patient is in the bathroom (after anesthesia)
G-Use wheelchairs for unsteady patients
I-Fall assessment completed by PAT
O-Have PT provide walker training for total knees
G-Make sure crutches are fit properly to patient
N-Provide crutch training as needed
G-Risk factors: Patient has a visual impairment
B-Make sure pediatric beds have padded siderails
B-Risk factors: Patient on multiple medications
O-Name a Risk Factor:
_____________
N-Risk factors: Patient uses assistive devices (cane, walker, etc.)
N-Use gait belt as needed
O-Use of siderails on patient bed
G-Risk factors at home: Tripping on loose rugs
I-Use safety belts in the OR
I-Patients should wear non-slip socks
B-Use Fall Risk wristbands for high risk patients
