Use the fall alarm assessment tool below to identify patients / residents at high risk for falling and need for a fall alarm.
Patients / residents with one or more of the following are candidates for a fall alarm:
- Mobility impairment (impaired bed, chair and/or toilet transfers)
- Gait/ balance impairment
- Impaired vision affecting mobility
- Uses cane/walker
- Cognitive Impairment
- Dizziness
- Bladder impairment (frequent nocturia/requires scheduled toileting)
- Exhibits unsafe/impulsive behavior
- Lacks understanding of mobility limitations
- Change of condition
- New admission
- Post fall
| Risk/Injury Factor | Comments |
| Mobility Impairment
__Bed __Chair __Toilet __Gait/balance impairment __Impaired vision affecting mobility __Bladder impairment affecting mobility __Dizziness affecting mobility __Uses cane/walker __Requires mobility assistance __Requires toileting assistance |
|
|
Impaired Cognition __Dementia __Depression __Delirium __Impaired 'safety' judgment __Disruptive behaviors __Non-English speaking __Exhibits unsafe/impulsive behavior __Lacks understanding of mobility limitations |
|
|
Situational __New admission __Change of condition __Post fall |
Posted May 2010
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