| RN |
- Conducts or supervises accurate assessment and documentation of assessment of fall risk factors on admission, daily, and if condition deteriorates (or according to facility policy).
- Documents care plan tied to identified risk:
- Mental status.
- Continence.
- Mobility level.
- Environmental risks (e.g., hooked up to IV).
- Performs or supervises performance of care plan procedures or treatments:
- Close observation of delirious patients.
- Toileting schedule.
- Use of assistive devices.
- Maintenance of clutter-free environment.
- Files incident report for new falls and carries out postfall assessment.
- Educates patient/family about fall risk factors.
|
| LPN |
- Conducts accurate assessment and documents assessment of fall risk factors on admission, daily, and if condition deteriorates (or according to facility policy).
- Documents care plan tied to identified risk:
- Mental status.
- Continence.
- Mobility level.
- Environmental risks (e.g., hooked up to IV).
- Performs or supervises performance of care plan procedures or treatments:
- Close observation of delirious patients.
- Toileting schedule.
- Use of assistive devices.
- Maintenance of clutter-free environment.
- Collaborates with other staff to ensure timely and accurate reporting of any falls and completion of postfall assessment.
|
| CNA |
- Reports any new fall risks to nurse.
- Keeps environment around bed clutter free.
- Offers assistance with toileting for patients with frequent toileting needs.
- Keeps assistive devices within easy reach of patient.
|
| Treating medical provider (e.g., physician, nurse practitioner, physician assistant) |
- Reviews needs for specific types of rehabilitation therapy and orders such therapy, if appropriate.
- Writes orders for activity level.
- Reviews medications for fall risk.
|
| Physical and/or occupational therapist |
- Assesses patient's function and mobility levels according to scheduled protocol (e.g., after orthopedic procedures) or upon consultation.
- Determines need for assistive devices and exercise program according to scheduled protocol (e.g., in rehabilitation unit) or upon consultation.
- Educates patient and family on safety with transfers and ambulation.
|
| Pharmacist |
- Reviews medication lists of patients at high risk based on medication profile.
- Discusses medications that may increase fall risk with physician using standardized approach (e.g., note in chart, rounds with hospitalist).
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| Environmental services staff |
- Responds to reports of fall hazards (e.g., spills).
- Keeps rooms and hallways free of clutter.
|
| Dietitian |
- Monitors patient's weight and nutritional status to avoid unintentional weight loss and loss of muscle mass.
- Provides tube feed regimens that maximize mobility (e.g., choosing bolus rather than continuous tube feeding where appropriate).
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| Patient educator |
- Works with nurse to provide appropriate educational materials and teaching to patients at risk for falls and their families.
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| Facilities engineer |
- Participates in regularly scheduled environmental rounds to identify equipment in need of repair.
- Responds to repair requests submitted by unit staff.
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| Information technology support personnel |
For units with electronic health records:
- Develops or refines documentation systems for fall risk assessment and care planning.
- Develops or refines computerized order sets (e.g., mobility protocol).
- Implements computerized alerts for medications that present high risk for falls, where appropriate.
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