FACILITY NAME COMPREHENSIVE PLAN OF CARE
PROBLEM(S) GOAL(S) APPROACH(ES) DEPT REVIEW _
High risk for falls related Will remain free of falls Gather information on N,SW to:______and/or injury related to past falls and attempt to ______falls through review date. determine cause of falls. ______Anticipate and intervene ______to prevent future ______recurrence.
Be sure call light is within ALL reach and encourage to use it for assistance as needed. Respond promptly to all requests for assistance.
Anticipate and meet ALL needs.
Coordinate with ALL appropriate staff to ensure a safe environment with: Floors even and free from spills or clutter Adequate, glare-free light Call light Bed in low position at night Side rails as ordered Handrails on walls Personal items within reach
PT evaluate and treat as PT ordered or prn.
Evaluate for, supply PT adaptive equipment or devices as needed. Reevaluate as needed for continued appropriateness and to ensure least restrictive device or restraint.
Provide activities that ACT minimize the potential for falls while providing diversion and distraction.
Resident Name Med Rec# Room# MD Name______
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PROBLEM(S) GOAL(S) APPROACH(ES) DEPT REVIEW _
Falls (continued) Encourage activities that ACT promote exercise, physical activity for strengthening and improved mobility.
Ensure that resident is N wearing appropriate footwear (shoes, bedroom slippers, non- skid socks) when ambulating or up in w/c.
Provide education, N,PT including safety reminders, what to do if a fall occurs.
Resident Name Med Rec# Room# MD Name______
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