Fall Prevention K-Card

HAC SPS Bundle Elements

Which department are you completing this survey for?

Name of the employee observed:

Has the patient been screened for falls?

Screen on admission and at interval(s) defined by the selected fall risk assessment tool.  

Consider using a fall risk assessment tool that includes variables specific to the pediatric population. 

Screen patient for history of fall within the last 3 months.
Does the patient have on fall risk identifiers per policy?

Identify patients are risk for falls by signage, armbands or other identifiers.

Communicate fall risk at handoff:

  At shift change (nurse to nurse)

  At time of transfer in care (unit to unit)

  Nurse to other (Child Life Specialist, Radiology Technician, etc.)
Is the environment safe and clear to reduce the risk of falls?

Ensure unused equipment is removed and pathways to door and bathroom are clear.

Clutter in room is minimized.

Non-skid footwear for ambulating patients.

Call light is within reach; orient to use periodically.

Use of appropriate sized clothing to prevent tripping.

Bed in low position with brakes on.

Appropriate sized bed is used (no co-bedding). 

Evaluate for gaps in the bed railings that may allow the child to slip.

Wheelchair and commode brakes are locked during transfers. 
Has family education been performed and documented on patients' fall risk?

Parents/guardian/family members have an integral role in a falls risk prevention program.

Parent/guardian/family education regarding fall risks of hospitalized children is important.   

Educate parents/guardians/family on safe environment. 
Comments

If any No is chosen above, please provide more details.