AHRQ’s Safety Program for Nursing Homes: On-Time Falls Prevention
Falls Prevention Self-Assessment Worksheet
The Self-Assessment Worksheet is a worksheet designed to help staff review how they currently identify residents who have experienced a change in falls risk, how they determine if new clinical interventions are needed, and how they determine what those interventions are. The self-assessment tool is intended to help identify the current processes and structures the nursing home uses to prevent falls and identify gaps and places for improvement. It is intended to help staff think about ways to transform these processes and how to begin to use the falls risk report in clinical discussions.
The self-assessment tool is an important first step in implementing the reports into current workflow. The team is expected to use the Self-Assessment Worksheet to help understand current fall prevention practices. This is the first step to help them determine how to transform their current practices and to identify ways to incorporate the On-Time Reports into current practice.
It is expected that the Facilitator will work with the Change Team to identify gaps in current falls prevention practices and help them see ways to incorporate the reports to improve these practices and improve clinical interventions. The Self-Assessment Worksheet assists the Change Team to identify how they:
- Determine which residents are at high risk for falls,
- Develop interventions to prevent falls,
- Discuss at-risk residents and formulate changes in care plans, and
- Carry out investigations, including root cause analysis, when an injurious fall occurs.
The assessment has four sections:
- Section 1: Screening for Falls Risk
- Section 2: Falls Prevention Plan
- Section 3: Investigations/Root Cause Analysis of Resident Falls
- Section 4: Communication Practices
Users and Uses
The main users are members of the Falls Prevention Change Team. The worksheet is designed so that the team answers a series of questions that guide them through an assessment of how they currently prevent injurious falls. Once they fill out the self-assessment and discuss it as a team, they will be better able to summarize gaps in current practices and consider ways the reports can help fill in the gaps.
The use of On-Time Falls Prevention not only helps improve risk identification and communication of risk with use of the reports, but also helps enhance the interdisciplinary nature of clinical decision making. An On-Time Facilitator will help guide the Change Team through this process.