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.
Specific instructions for use are included in the assessment, which may be downloaded for electronic entry or printed for handwritten entry. The checklist is a PDF and requires Adobe Reader to view and/or use the electronic entry feature.
Falls Prevention Process Measures Audit ToolThis audit tool is intended to help assess compliance with falls prevention practices most commonly included as part of hospital falls prevention plans.
Specific instructions for use are included in the audit tool, which may be downloaded for electronic entry or printed for handwritten entry. The audit tool is a PDF and requires Adobe Reader to view and/or use the electronic entry feature.
Falls Risk Checklist
This sample checklist can help determine whether the facility’s falls risk assessment tool screens for certain risk factors associated with greater risk of falls and falls with injury.
Specific instructions for use are included in the checklist, which may be downloaded for electronic entry or printed for handwritten entry. The checklist is a PDF and requires Adobe Reader to view and/or use the electronic entry feature.
Falls Self-Assessment Tool Action Plan
After completing a self-assessment tool (SAT), your falls prevention team is encouraged to create an action plan targeted to any best-practice elements that were identified on the SAT as missing or incompletely implemented in your facility’s current falls prevention program.
Specific instructions for use are included in the action plan, which may be downloaded for electronic entry or printed for handwritten entry. The action plan is a PDF and requires Adobe Reader to view and/or use the electronic entry feature.
Falls with Harm Savings Calculator
This sample falls with harm savings calculator for hospitals can be used to calculate the average additional cost of falls with serious injury, additional days, and cost savings associated with reductions in falls with serious injury.
The tool is in Microsoft Excel format and requires Excel to view and/or use the electronic entry feature.
Note: to download a copy or if the link fails to open, please right-click on the link below and select "save target as."
Hospital Engagement Network Falls Reduction and Prevention Collaboration Self-Assessment Tool
This self-assessment is intended to serve as a tool to evaluate the current structure and content of a hospital falls prevention program, compared with evidence-based best-practice guidelines, and to identify opportunities for improvement.
Specific instructions for use are included in the assessment tool, which may be downloaded for electronic entry or printed for handwritten entry. The assessment tool is a PDF and requires Adobe Reader to view and/or use the electronic entry feature.
PA-PSRS Falls Event Type Decision Tree for Hospital Users
This decision tree is intended as a guide to help staff systematically evaluate the circumstances after a patient falls and assign an event type in the Pennsylvania Patient Safety Reporting System.
Pennsylvania Hospital Engagement Network: Falls Reduction and Prevention Collaboration Postfall Investigation Tool
The Postfall Investigation (PFI) Tool is designed to be used to collect information following a patient fall.
Hospital Improvement Innovation Network Injury from Falls and Immobility Postfall Investigation Data Collection Workbook
This data collection workbook is designed to be used for aggregating data about falls through use of the Pennsylvania Hospital Engagement Network Falls Reduction and Prevention Collaboration Postfall Investigation Tool.
Specific instructions for use are included in the tool, which may be downloaded for electronic entry or printed for handwritten entry. The tool is a PDF and requires Adobe Reader to view and/or use the electronic entry feature.
Radiology Falls Risk Assessment Tool
This sample assessment tool may be used to alert radiologic technologists to a patient’s risks for falls.
Specific instructions for use are included in the form, which may be downloaded for electronic entry or printed for handwritten entry. The form is a PDF and requires Adobe Reader to view and/or use the electronic entry feature.
