Template

General Patient Fall Risk Assessment Template

100+

This fall risk assessment template is used to evaluate a patient's probability of falling. It includes fields to record a patient's fall history, current medication, and medical test results (vision, peripheral sensation, and mobility). Record the patient's fall risk rating depending on the number of accumulated risk factors. If a patient gets 1-2 risk factors patient has a Low risk probability of falling, a Medium risk for 3-5 risk factors and High risk for 6 risk factors and above.

With Mitti you can

Digitize any process, procedure or policy

Eliminate mistakes made by paper-based processes

Create and share professional reports instantly

Confirm accountability and compliance with a digital log

With Mitti you can

Digitize any process, procedure or policy

Eliminate mistakes made by paper-based processes

Create and share professional reports instantly

Confirm accountability and compliance with a digital log

About author

Mitti

Mitti (by SafetyCulture) is the operations system for every site, shift and standard. Trusted by 80,000 organizations in 190 countries, Mitti publishes free checklists, SOP templates, audit checklists and toolbox talk topics that turn paper processes into a digital audit trail. Download one, put it to work on your next inspection or shift, and see why teams keep coming back for more.

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Healthcare practitioners can use this template to prepare a risk management plan for a patient. Identify mental health related risk factors and document actions to minimize risks and desired outcomes. Agree the risk management plan with the patient and get sign-off from both patient and practitioner.

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Template

Fall Risk Assessment Audit Checklist

Use this hospital-focused audit to check the accuracy and compliance of fall risk assessments at admission and every shift. Verify patient and clinical factors, mental status, gait, ambulatory aids, and defined risk levels. Review environment hazards, patient participation, and staff education on prevention. Capture findings, spot teaching, staff involved, and signatures to ensure documentation is complete and standards are met.

by Ega Vinolia Santha Kumari.B, from the Community

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Use this Patient Sign in Sheet Template to track patient attendance. This can help record information such as the time of appointment, assigned doctor, and time of patient's arrival. Use SafetyCulture to generate offline reports and track patient attendance.

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Morse Fall Risk Assessment

This Morse Fall Risk Assessment Tool derived from the Morse Fall Scale (MFS) was converted using SafetyCulture and is used to help assess a patient's likelihood of falling. Perform this Morse Fall Risk Assessment by answering 6 essential questions. This template includes a risk rating table which will help you assign a fall risk rating (High, Medium, Low) based on the responses to the 6 essential questions.

by Mitti

200+

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