staff on units preparing to implement the fall prevention program 1B Stakeholder Analysis Implementation Team leader (e.g., senior – manager or quality improvement/safety/risk manager) 1C Leadership Support Assessment Implementation Team leader – 1D Business Case Form Implementation Team leader – 1E Resource Needs Assessment Implementation Team leader – 1F Organizational Readiness Checklist Implementation Team leader – 2A Interdisciplinary Team Implementation Team leader – 2B Quality Improvement Process Implementation Team leader – 2C Current Process Analysis Individuals designated by the – Implementation Team leader 2D Assessing Current Fall Prevention Policies Individuals designated by the – and Practices Implementation Team leader 2E Falls Knowledge Test Staff nurses and nursing assistants – 2F Action Plan Implementation Team leader with quality – improvement/safety/risk manager 2G - Managing Change Checklist Implementation Team leader 3A Master Clinical Pathway for Inpatient Falls Quality improvement/safety/risk – manager, staff nurses, and nursing assistants 3B Scheduled Rounding Protocol Unit manager, staff nurses, and nursing – assistants 3C Tool Covering Environmental Safety at the Unit manager and facility engineer – Bedside 3D Hazard Report Form Any hospital employee who enters – patient rooms 3E Clinical Pathway for Safe Patient Handling Nurse manager, staff nurses, and nursing – assistants 3H Morse Fall Scale for Identifying Fall Risk Staff nurses – Factors* 3G STRATIFY Scale for Identifying Fall Risk Staff nurses – Factors* 3I Medication Fall Risk Scale and Evaluation Pharmacist and staff nurses – Tools* 3F Orthostatic Vital Sign Measurement Staff nurses and nursing assistants – 3J Delirium Evaluation Bundle: Digit Span, Physicians, nurse practitioners, physician – Short Portable Mental Status Questionnaire, and assistants Confusion Assessment Method* 3K Algorithm for Mobilizing Patients* Nursing assistants – 3L Patient and Family Education Educators, staff nurses – 3M Sample Care Plan* Staff nurses with input from other –
staff on units preparing to implement the fall prevention program 1B – Stakeholder Analysis Implementation Team leader (e.g., senior manager or quality improvement/safety/risk manager) 1C – Leadership Support Assessment Implementation Team leader 1D – Business Case Form Implementation Team leader 1E – Resource Needs Assessment Implementation Team leader 1F – Organizational Readiness Checklist Implementation Team leader 2A – Interdisciplinary Team Implementation Team leader 2B – Quality Improvement Process Implementation Team leader 2C – Current Process Analysis Individuals designated by the Implementation Team leader 2D – Assessing Current Fall Prevention Policies and Practices Individuals designated by the Implementation Team leader 2E – Falls Knowledge Test Staff nurses and nursing assistants 2F – Action Plan Implementation Team leader with quality improvement/safety/risk manager 2G - Managing Change Checklist Implementation Team leader 3A – Master Clinical Pathway for Inpatient Falls Quality improvement/safety/risk manager, staff nurses, and nursing assistants 3B – Scheduled Rounding Protocol Unit manager, staff nurses, and nursing assistants 3C – Tool Covering Environmental Safety at the Bedside Unit manager and facility engineer 3D – Hazard Report Form Any hospital employee who enters patient rooms 3E – Clinical Pathway for Safe Patient Handling Nurse manager, staff nurses, and nursing assistants 3H – Morse Fall Scale for Identifying Fall Risk Factors* Staff nurses 3G – STRATIFY Scale for Identifying Fall Risk Factors* Staff nurses 3I – Medication Fall Risk Scale and Evaluation Tools* Pharmacist and staff nurses 3F – Orthostatic Vital Sign Measurement Staff nurses and nursing assistants 3J – Delirium Evaluation Bundle: Digit Span, Short Portable Mental Status Questionnaire, and Confusion Assessment Method* Physicians, nurse practitioners, physician assistants 3K – Algorithm for Mobilizing Patients* Nursing assistants 3L – Patient and Family Education Educators, staff nurses 3M – Sample Care Plan* Staff nurses with input from other
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