Environmental Safety

Spills cleaned up immediately

Keep floors clutter/obstacle-free (with attention to the path between bed and bathroom/commode)

Decrease shine on floors

Level floors (no step up or down into shower, bathroom, no area rugs)

Even colored floor

Handrails are distinctly different color from walls

Handrails and transfer poles are clear for use

Secure lacks on beds, stretchers, and wheelchairs

Furniture secured to the floor or moved so there is a clear path around it

Chair/bench placed strategically in hallways to provide a rest area for person’s with limited endurance

Remove excess equipment/supplies/furniture from room

Secure excess electrical and telephone wires

Secure safety around the bed environment (use of transfer poles, transfer assist rails)

Place call light and frequently used objects within patient reach

Assure adequate lighting, especially at night

Bathrooms are large enough to bring in wheelchairs and walking aids

Adaptive equipment in bathrooms (vertical, horizontal, diagonal grab bars near toilet and shower; raised toilet seat or commode; rubber-backed bath mat; shower seat; hand-held showerhead)

Sink, toilet, soap and paper towel holder at low enough level to reach from wheelchair or standing

Patient Safety

Orient patients to surroundings, including bathroom, use of bed, and location of call light

Encourage patients/families to call for assistance when needed

Use properly fining nonskid footwear

Assure ambulation as ordered

Evaluate the patient's ability to interpret information

Evaluate potential medication side effects

Keep assistive devices at bedside within reach

Assess and assist the patient in the following daily routine (schedule):

Assess mobility and gait as necessary

Assess mental status, cognition, and ability to perform activities of daily living (ADL)

Assess medications daily

Inspector's Full Name and Signature