Get Mhca Fall Prevention Mentorship Program: Post-fall Evaluation - Mnhomecare

Completing the MHCA Fall Prevention Mentorship Program: Post-Fall Evaluation is crucial for understanding and preventing future falls for patients. This guide will provide you with step-by-step instructions on how to effectively fill out the evaluation form online.

Follow the steps to complete your evaluation form accurately.

1. Begin by selecting the 'Get Form' button to obtain the evaluation form and open it in the online editor.
2. Fill out the 'Patient' section with the full name of the individual being evaluated.
3. Indicate the disciplines involved in the care provided by marking the relevant boxes, such as SN (Skilled Nursing), PT (Physical Therapy), or OT (Occupational Therapy).
4. Enter the 'Date of Birth' and 'Clinician' fields with the appropriate information.
5. Provide the 'Date of Fall' and 'Time' of the incident, ensuring accuracy for proper documentation.
6. Specify whether the patient lives alone by marking 'Yes' or 'No' as applicable.
7. Indicate if the fall was 'Observed by staff' or 'Not observed', providing the name of the individual who reported it if relevant.
8. Answer whether the fall resulted in an injury and provide details if it did.
9. Record if the patient experienced a previous fall in the last three months by selecting 'Yes' or 'No'.
10. Indicate whether the fall resulted in emergent care or hospitalization.
11. Note if the patient uses any assistive devices, specifying the type if applicable.
12. State whether the assistive device was in use at the time of the fall.
13. Mark whether therapy was involved prior to the fall, specifying the type if applicable.
14. Record the location of the fall by selecting the relevant option.
15. List any recent changes in the patient’s health status, such as blood pressure or mobility changes.
16. Document any changes to medications that may have contributed to the fall.
17. Identify any contributing factors that may have led to the fall.
18. Confirm whether the physician and other team members have been notified, including the date and time of notification.
19. Provide a narrative description of the fall, detailing the circumstances during the incident.
20. In the action plan section, indicate any updates to the patient care plan or adjustments to medications and services.
21. Complete the signature section of the report, ensuring to date it appropriately.
22. If required, note the review by management and the submission to Quality Management.
23. Finally, consider saving any changes, downloading, printing, or sharing the completed form as necessary.

Complete the MHCA Fall Prevention Mentorship Program: Post-Fall Evaluation online to enhance patient safety and care.