Ambulatory Surgical Facility Falls Risk Assessment Tool

Ambulatory surgical facilities can use this tool to screen patients for falls risk at three intervals: pre-admission, pre-operatively, and post-operatively. Complete all sections and implement falls prevention interventions in accordance with facility-specific protocols. Obtain information to complete the questions from the patient, the patient’s designee, a healthcare provider, a handoff form, or through observation.

Specific instructions for use are included in the assessment, which may be downloaded for electronic entry or printed for handwritten entry.

Ambulatory Surgical Facility Falls Risk Assessment Tool 

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