Department: Diagnosis: Risk factor assessment for falls: □1. Unexplained falls in the last year (1 point) □4. Mobility disorders, hemiparesis of limbs (3 points) □7. Dizziness, vertigo, postural hypotension (2 points) □8. Taking medication that affects consciousness or mobility (1 point) □Pupil-diluting agent □9. No family member or other person accompanying the patient during hospitalization (1 point) Current assessment score: Points □ Sedative and sleeping agent □ Hypotensive and diuretic □ Sedative and antiepileptic □ Narcotic and analgesic □ 2. Consciousness impairment (1 point) □ 5. Age ≥65 years (1 point) □ 3. Visual impairment (1 point) □ 6. Physical weakness (3 points) Bed No.: Name: Sex: Age: Inpatient No.: Month and year Admission or transfer date:
□ 10. Intravenous fluid therapy (1 point)
Remarks: 1. Patients ≥65 years of age or older and clinically at risk for falls are assessed on admission. 2、Condition change or use of fall-prone drugs (sedatives, antihypertensive drugs, anesthetic analgesics, etc.) shall be evaluated. 3、≥4 points for high risk of injury/fall/bed fall, reassessed weekly.
Preventive measures for high-risk falls and bed fall: □1. Place pagers in a location easily accessible to patients and guide patients to familiarize themselves with the ward environment. □2. Avoid wearing inappropriate sized shoes (or slippers), and use appropriate walking aids to assist the patient's mobility. □3. No matter when the patient is lying down or getting out of bed to move around, there should be a companion beside the patient at all times. □4. Pay attention to the patient's condition after taking medication. If the patient feels dizzy or weak, make sure he/she rests in bed and inform the medical staff. □5. If the patient is unconscious or moving around, use a restraining belt for the patient's safety. □6. When going to the bathroom to use the toilet, please do not leave the patient when accompanied. □7. If the medical equipment in the ward is damaged or difficult to use (lights, etc.), please notify the medical staff immediately. □8. Teach hemiplegic patients to get in and out of bed by the edge of the bed on the healthy side. □9. Signs for patients at high risk of falling are available. □10. Follow the "3 steps" for position change: 30 seconds lying down, 30 seconds sitting up, 30 seconds standing up, and then walking. Avoid sudden changes in position, especially at night. Relationship to Patient: Date: Evaluator Year Month Evaluator: Month Date: Month Month Month
Evaluator.