Appendix B Patient Patient Date Shift Day Location Activity Length Level ID # age of fall of fall of of fall at time of Stay of week of fall Injury of fall Fall Scale Key Shift: 7a-7p= A, 7p-7a=P Activity at time of fall: Ambulating=1, Getting OOB=2, Standing up=3, Sitting down=4, Toileting=5, Sleeping=6, Chair=7, Wheelchair=8 Primary Diagnosis: Neurologic=1, Hematology/Oncology=2, GI=3, Infectious disease=4, Respiratory=5, Cardiac=6, ENT=7, Renal=8, Orthopedic=9, Metabolic/endocrine=10, Psychiatric=11, Unknown/other=12 Level of Injury: None=1, Minor=2, Moderate=3, Major=4, Death=5 Location of fall: Patient room=1, Hallway=2, Bathroom=3, Radiology/T&T=4
Appendix B Patient ID # Patient age Date of fall Shift of fall Day of week of fall Location of fall Activity at time of fall Fall Scale Length of Stay Level of Injury Key Shift: 7a-7p= A, 7p-7a=P Activity at time of fall: Ambulating=1, Getting OOB=2, Standing up=3, Sitting down=4, Toileting=5, Sleeping=6, Chair=7, Wheelchair=8 Primary Diagnosis: Neurologic=1, Hematology/Oncology=2, GI=3, Infectious disease=4, Respiratory=5, Cardiac=6, ENT=7, Renal=8, Orthopedic=9, Metabolic/endocrine=10, Psychiatric=11, Unknown/other=12 Level of Injury: None=1, Minor=2, Moderate=3, Major=4, Death=5 Location of fall: Patient room=1, Hallway=2, Bathroom=3, Radiology/T&T=4
jennifer_smith_final_developing_an_evidence-based_multidisciplinary_fall_reduction_program.docx