[nrsbetrn]

Does anyone have a falls risk assessment fo peds. We just went through a Joint Commission survey and they want us to have a risk assessment for peds in the home setting. Can you share with me please?

[caliotter3]

Have one somewhere, but have to find it. When I find it I will post for you.

[caliotter3]

Haven't been able to locate the one for peds yet but did find one for adult. Maybe you could modify this. It has a lot on it about ambulating, so that wouldn't be appropriate for anyone who doesn't walk yet. Will continue looking for the peds one for you. This is typed out in a straight format. On the form there are nice boxes for everything.

Adult Fall Risk Assessment Tool
Instructions: Check applicable items and add total score
Category:
I. Age
80 or more years old 3
70-79 years old 1
II. Mental Status
Oriented at all times 0
Confused at all times 3
Intermittent confusion 2
III. Recent Hospitalization
Within last month 2
IV. Elimination
100% dependent 0
Catheter and/or ostomy 1
Elim. with assistance 3
Independent & continent 5
V. Falling within past 6 mos
No hx of falling 0
Has fallen 1or2times before 2
Hx of mult falls/fractures 5
VI. Visual impairment
Visually impaired 1
Wears glasses 1

Assess the pt's gait by having him/her: 1)Stand in 1 spot with both feet on ground
for 30 sec without holding onto something; 2)walk straight forward; 3)walk through
doorway; 4)walk making a turn

VII. Gait and Balance
Wide base support 1
Loss of balance while
standing 1
Balance probs when walking 1
Decrease of muscular
coordination 1
Lurching,swayingorslapping
gait 1
When walking thru a door-
way holds on or changes
gait pattern 1
Jerking or instability when
making turns 1
Use of furniture when trans-
ferring or walking 1
VIII. Meds

ETOH Anesthetic Antihistamines Antihypertensives
Cathartics Diuretics Hypoglycemic Narcotics
Sed/hypnotics Anticonvulsants Psychotropics Benzodiazepines Other

IX. How many meds from the above groups is pt taking?
No meds 0
One med 1
Two or more meds 2
With a change of med and/or dosage in the past 5 days, add one point to the med
score.

Drop in systolic bp of 20 mg Hg or more between lying and standing 2

X. Impairments
Limited ROM/muscle strength 0
None 1
Arm(s) 1
Leg(s) 2

Environment clear 0
cluttered 1

A score of 10 or above indicates a risk of falling. Reassessment to be completed at
least annually or more often as risk indicates.
(HTH)

[nrsbetrn]

Thanks for the info. I have an assessment for adults but need one for peds. Thanks for looking and let me know if you find something.

[caliotter3]

Still looking for the peds version. Got boxes of junk to go though. When I find it, will be sure to provide the info. As a matter of fact, I may have had two versions of a peds fall risk assessment. Just have to find them.