HD Falls Audit for Inpatient and Maternal
Audit Form
HD Intervention Audits
HDS Assessment Scoring Audits
Audit Area
Inpatient
Maternal
Audit Date
Hospital System
A Demo
A Demo LD
Advocate Health
Advocate Health ED
Appleton Area Health
Aspirus
Astera Health
CentraCare
Craig Hospital
Demo System
Emory
First Health
Grady
Henry Ford
Houston Methodist
HSHS
KP Mid Atlantic
KP NW
KP SCALHI
KP Seattle Capitol Hill
LCMC
Mary Greeley
Meeker Memorial
Mosaic Life Care
Overlake Medical Center
Parkland
SIH
St Tammany
UAMS
University of Illinois Chicago
UT Southwestern
VCU
White River
Willis Knighton
Hospital Name
Unit Name
Inpatient Intervention Audit
Maternal Intervention Audit
Total Criteria Met
Total Criteria Unmet
HDS© Score Correct
mHDS© Score Correct
Fall ID on patient (arm band, yellow gown or yellow socks)
Patient/Family Education Documented
Care Plan (Interventions) Individualized
Correct Fall Sign in Place
Mats and Alarms
MODERATE >=2 (Mental Status/Mobility) - Mats in place
MODERATE >=2 (Mental Status/Mobility) - Alarms in place and activated to correct zone
HIGH >=15 - Mats in place
HIGH >=15 - Alarms in place and activated to correct zone
Mats and Alarms
MODERATE >=3 (Mental Status) - Mats in place
MODERATE >=3 (Mental Status) - Alarms in place and activated to correct zone
HIGH >=3 (Mental Status) - Mats in place
HIGH >=3 (Mental Status) - Alarms in place and activated to correct zone
Scoring Audit
Total Scored Correctly
Total Scored Incorrectly
Mobility
Medications
Mental Status/LOC/Awareness
Elimination Needs
Volume/Electrolyte Status
Communication Sensory
Behavioral
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