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  2. 2014
  3. January
  4. P
  5. Post Fall Huddle
0%
Exit Survey
 
 
Date
 
 
 
Time of Fall
 
 
 
Time of Huddle
 
 
 
Unit
 
3 West
 
3 East
 
Med Surg
 
Med Surg Overflow
 
ICU
 
Rehab
 
OB
 
SDS
 
Home Health
 
 
 
Location Fall Occurred
 
Patient's Room
 
Bathroom
 
Hallway
 
Dayroom
 
 
 
Fall
 
Assisted
 
Unassisted
 
 
 
Witnessed
 
Yes
 
No
 
 
 
Patient already on fall precautions?
 
Yes
 
No
 
 
 
Activity Prior to Fall
 
Ambulating
 
In bed
 
Toileting
 
Bedside Commode
 
Transferring
 
Chair
 
Wheelchair
 
 
 
Patient's Statement: "I fell because________________