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Tool 3C: Tool Covering Environmental Safety at the Bedside

Preventing Falls in Hospitals: A Toolkit for Improving Quality of Care

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Background: Facility safety is key to preventing falls in the hospital.

Reference: Adapted from AHRQ publication on the Falls Management Program for nursing homes. Available at: www.ahrq.gov/professionals/systems/long-term-care/fallspx/fallspxmanual.htm.

How to use this tool: This tool contains an inspection checklist to be completed jointly by the unit manager and facility engineer to identify and resolve environmental safety issues in hospital rooms. The inspection is designed to be performed room by room and bed by bed within each room (if rooms are not private).

Use the results from the inspection process to determine which items require attention by the nursing staff or maintenance or replacement by the facility engineers. Additional guidance for engineers about maintenance and repairs may be found at: www.ahrq.gov/professionals/systems/long-term-care/fallspx/fallspxmanapd.htm.

Inspection List

Write the unit name, date, and room numbers across the top line. Put the bed number or letter across the second line and sign it. Put an "X" under the room number and bed beside all the tasks that need to be done (leave blank if no safety issue is identified or problem can be fixed immediately). Indicate whether this task should be completed by the nursing staff or facilities staff in the Assigned column. Tasks that are typically completed by the facility engineers are denoted with an "(f)." Write notes about special problems or add details in the Notes column.

UnitDate:Room Number:       Assigned toNotes
Signature:Bed:                
1. PathsRemove unused equipment (canes/walkers)                
Remove bedside commode, if unused                
With patient's permission, rearrange room to clear paths                
Put the bedside table next to the bed or across bed                
Remove unused items from bathroom and store elsewhere                
Make tiebacks for divider curtains              (f) 
Tie electrical cords out of path (TV, phone)              (f) 
2. FurnitureAdjust bed into locked position.                
Replace unstable bed with a stable one                
Push bed to wall (check local and state fire codes)                
Remove all lightweight or unstable furniture                
Clean, repair, or replace broken bed wheel locks              (f) 
Fix unstable furniture              (f) 
Secure loose bathroom handrails              (f) 
Replace missing rubber tips on bedside commode              (f) 
Replace missing rubber tips on handrails that rest on floor              (f) 
Secure raised toilet seat to commode              (f) 
3. Easy AccessArrange room so that items are within patient's reach (e.g., walking aids are within safe reach)              (f) 
4. FloorRepair or replace floor covering              (f) 
Replace high, broken, or missing thresholds              (f) 
Add grading to thresholds between room and bathroom              (f) 
5. LightingReplace burned out or flickering bulbs. Use max wattage              (f) 
Repair broken room lights or call lights              (f) 
Replace broken call light cords or lengthen cords              (f) 
6. EquipmentInspect wheelchair (for all wheelchairs found)              (f) 
Repair cane              (f) 
Repair walker              (f) 

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Current as of January 2013
Internet Citation: Tool 3C: Tool Covering Environmental Safety at the Bedside: Preventing Falls in Hospitals: A Toolkit for Improving Quality of Care. January 2013. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/professionals/systems/long-term-care/resources/injuries/fallpxtoolkit/fallpxtk-tool3c.html