Risk Factor | Scale | Score |
---|---|---|
History of Falls | Yes | 25 |
No | 0 | |
Secondary Diagnosis | Yes | 15 |
No | 0 | |
Ambulatory Aid | Furniture | 30 |
Crutches/ Cane/ Walker | 15 | |
None / Bed Rest / Wheel Chair / Nurse | 0 | |
IV / Heparin Lock | Yes | 20 |
No | 0 | |
Gait / Transferring | Impaired | 20 |
Weak | 10 | |
Normal / Bed Rest / Immobile | 0 | |
Mental status | Forgets Limitations | 15 |
Oriented to Own Ability | 0 |