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Track Fall-Related Injuries With This Tool

Providers can use the following format to track residents' falls and update the plan of care.

* Injury Codes

0 = None (no injury)

1 = Minor - no Tx required (bumps, bruises)

2 = Moderate (requires some interventions and/or physician order but not physician intervention, such as abrasions, skin tears, lacerations, treated in-house or X-ray that was negative)

3 = Severe (requires intervention and physician input and/or intervention, e.g., fracture, sprain, concussion, subdural hematoma, sutures, physician office visits, trip to emergency room and/or hospitalization)

Resident's Name _________________

Medical Record #______________

Source: Joanne Rader, RN, MN, FAAN. Used by permission.

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