Appendix B1: The Falls Management Program Self-Assessment Tool

The Falls Management Program Manual

The purpose of the FMP Self-Assessment Tool is to identify what processes of care your facility has in place and what areas need improvement. It is divided into 7 areas of focus. Use your facility's policies, procedures, and general practices to answer the questions listed under the first 4 areas (A, B, C, D). To answer the questions listed under the last 3 areas (E, F, G) in the Chart Audit, select a minimum of 5 residents who have fallen during the last 6 months. Answer the questions based on the documentation you find in each resident's chart and care plan. Further instructions are provided in the Chart Audit section. Complete the Plan for Improvement when finished.

[D] Select for Text Description of all images.

First page of Self-Assessment Tool. Go to [D] Text Description for details.

Second page of Self-Assessment Tool. Go to [D] Text Description for details.

Third page of Self-Assessment Tool, Chart Audit. Go to [D] Text Description for details.

Fourth page of Self-Assessment Tool, Chart Audit. Go to [D] Text Description for details.

Final page of Self-Assessment Tool, Chart Audit. Go to [D] Text Description for details.

Self-Assessment Tool, Plan for Improvement. Go to [D] Text Description for details.

Current as of February 2010
Internet Citation: Appendix B1: The Falls Management Program Self-Assessment Tool: The Falls Management Program Manual. February 2010. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/professionals/systems/long-term-care/resources/injuries/fallspx/fallspxmanapb1.html