Get the free monthly falls tracking form - qio ipro

1- October 2010 Table of Contents INTRODUCTION. 1 MONTHLY FALLS TRACKING FORM with sample data. 1 AUTOMATIC CALCULATIONS AND GRAPHING. 13 FALLS STATISTICAL TRENDING REPORT. 14 FOR ADDITIONAL INFORMATION. 14 The MONTHLY FALLS TRACKING FORM was developed to assist facilities with a way to track their falls on a monthly basis. Guide to the Monthly Falls Tracking Form This material was developed and prepared by IPRO the Medicare Quality Improvement Organization for New York State under contract...

How to fill out monthly falls tracking form

How to fill out a monthly falls tracking form?

1. Begin by collecting all necessary information: Gather the date of each fall, the time it occurred, and the location where it took place.
2. Identify the person who experienced the fall: Write down the name or identifier of the individual who fell, whether it is a patient, an elderly person, or someone in a specific care facility.
3. Record the circumstances of the fall: Document any factors that may have contributed to the fall, such as tripping hazards, uneven surfaces, or insufficient lighting. Note if the fall was witnessed or if the individual was alone at the time.
4. Describe any injuries sustained: Note the extent of injuries, such as bruises, cuts, fractures, or head injuries. If medical attention was required, provide details of the treatment received.
5. Include information about the response: Write down the actions taken after the fall, whether it involved calling for medical assistance, contacting a caregiver or family member, or following any specific protocols.
6. Add any additional notes: Leave space for any additional comments or observations related to the fall. This can include any follow-up actions taken or recommendations for prevention.

Who needs a monthly falls tracking form?

1. Healthcare organizations: Hospitals, nursing homes, and other healthcare facilities use monthly falls tracking forms to monitor and analyze fall incidents within their premises. This helps identify patterns, implement preventive measures, and improve patient safety.
2. Caregivers and family members: Individuals responsible for the care of elderly or vulnerable people may use a monthly falls tracking form to keep a record of falls, assess their frequency, and discuss them with healthcare professionals if necessary.
3. Personal use: Anyone who wants to track their own falls or those of a family member can utilize a monthly falls tracking form. This can help identify potential risks, discuss concerns with healthcare providers, and take appropriate action to prevent future falls.

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What is monthly falls tracking form?

The monthly falls tracking form is a document used to record and monitor the number of falls that occur within a specific time period.

Who is required to file monthly falls tracking form?

Healthcare facilities, nursing homes, and assisted living centers are required to file monthly falls tracking forms.

How to fill out monthly falls tracking form?

The form typically requires information such as date of fall, time of fall, location of fall, description of fall, level of injury, and corrective actions taken.

What is the purpose of monthly falls tracking form?

The purpose of the monthly falls tracking form is to identify trends, assess risk factors, and implement interventions to prevent future falls.

What information must be reported on monthly falls tracking form?

Information such as date of fall, time of fall, location of fall, description of fall, level of injury, and corrective actions taken must be reported on the monthly falls tracking form.