The Falls Management Program: A Quality Improvement Initiative for Nursing Facilities

Appendix B28: Nursing 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 a √ under the room number and bed beside all the tasks that need to be done. Write notes about special problems or add details in the Notes column.

Unit Date: Room Number:               Notes:
Signature: Bed:                              
1. Paths Remove unused equipment (canes/walkers).                              
Instruct SW to ask family to remove unused items.                              
If bedside commode is unused, ask staff to remove it.                              
With resident's permission, rearrange room to clear paths.                              
Instruct staff to keep paths clear.                              
Instruct staff to keep overbed table across bed.                              
Remove unused items from bathroom and store elsewhere.                              
2. Furniture Instruct nursing staff and housekeepers to keep bed in locked position except during care or cleaning.                              
Replace unstable bed with a stable one.                              
Push bed to wall (check local and state fire codes).                              
Remove all cardboard, lightweight, or unstable furniture.                              
Instruct SW to ask family to remove or replace unstable items.                              
3. Easy Access Arrange room so that items are within resident's reach.                              
Instruct staff to keep items within arm's length of patient.                              
Instruct staff to place cane, walker, or w/c within safe reach.                              
5. Floor Instruct staff to wipe up all spills quickly.                              
7. Foot Care and Footwear Ask nurse for podiatry consult.                              
Instruct staff and resident to use specific shoes/slippers.                              
Instruct staff and resident to use nonskid socks.                              
Instruct SW to ask family to provide safe footwear.                              
Page last reviewed December 2017
Page originally created February 2010
Internet Citation: Appendix B28: Nursing Inspection List. Content last reviewed December 2017. Agency for Healthcare Research and Quality, Rockville, MD.