Falls Risk Assessment and

Management Plan (FRAMP)

WARD DOCTOR

SURNAME UMRN
GIVEN NAMES DOB GENDER
POSTCODE
ADDRESS
TELEPHONE

On this shift has the patient: NO to ALL

Been admitted or transferred from another ward; or Had a Confirm
fall; or Medically deteriorated or improved? YES to ANY previously
assessed
☐ Admitted ☐ Post Fall ☐ Ward Transfer interventions
Initial Screen are in place as
☐ Medical Condition Change ☐ Previous FRAMP full
per Shift
Does the patient meet any of the following: Tick Yes or No?
by Shift check
1. Had a fall in the past 12 months? ☐ Yes ☐ No
on page 3.
2. Unsteady when walking/transferring or uses a walking aid? ☐ Yes ☐ No
3. Confused, known cognitive impairment or incorrectly answers any of the following:
☐ Yes ☐ No
Age, Date of birth, Current year and Place?
4. Has urinary or faecal frequency/urgency or nocturia? ☐ Yes ☐ No
Name: Ward:
Designation: Date:
Time: Signature:

Re - Screen 1 ☐ Ward Transfer ☐ Post Fall ☐ Medical Condition Change

YES to ANY
Does the patient meet any of the following: Tick Yes or No?
Patient is a
1. Had a fall in the past 12 months? ☐ Yes ☐ No
FALLS RISK.
2. Unsteady when walking/transferring or uses a walking aid? ☐ Yes ☐ No
Complete
3. Confused, known cognitive impairment or incorrectly answers any of the following:
☐ Yes ☐ No pages 2, 3
Age, Date of birth, Current year and Place?
and 4.
4. Has urinary or faecal frequency/urgency or nocturia? ☐ Yes ☐ No
Name: Ward:
Designation: Date: NO to ALL
Time: Signature: Complete
page 3
Re - Screen 1 ☐ Ward Transfer ☐ Post Fall ☐ Medical Condition Change and check
Does the patient meet any of the following: Tick Yes or No? Minimum
1. Had a fall in the past 12 months? ☐ Yes ☐ No Interventions
2. Unsteady when walking/transferring or uses a walking aid? ☐ Yes ☐ No are in place.
3. Confused, known cognitive impairment or incorrectly answers any of the following:
☐ Yes ☐ No
Age, Date of birth, Current year and Place?
4. Has urinary or faecal frequency/urgency or nocturia? ☐ Yes ☐ No
Name: Ward:
Designation: Date:
Time: Signature:

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Legal entity: Health Careers International Pty Ltd. | ACN: 106 800 944 | ABN: 59 106 800 944 | RTO ID: 21985 | CRICOS Provider Code: 03386G

Education for Employment

 Falls Risk Assessment and
Management Plan (FRAMP)

Date
Initial Re- Re-
RISK ASSESSMENT and INDIVIDUALISED INTERVENTIONS Initial MOBILITY RISKS Screen Screen 1 Screen 2
Does the patient:
If risk identified initial box
Require assistance with mobility/transfer?
Have poor coordination, balance, gait or uncorrected visual impairment?
FUNCTIONAL ABILITY RISKS
Is the patient unsteady, disorganised or require assistance when attending to ADLs?
INTERVENTIONS Initial if appropriate for patient
Assess, document and provide mobility aids and level of assistance required.
Discuss and confirm with the patient what level of assistance they require (including mobility aids), and/or their
need to call and wait for assistance.
Refer to Physiotherapist for a comprehensive mobility assessment.
Refer to Occupational Therapist (OT) for functional assessment.
MEDICATIONS/MEDICAL CONDITION RISKS
If risk identified initial box
Some medications are associated with falls. Has the patient been prescribed:
• Psychoactive medication e.g. benzodiazepines, antipsychotics, antidepressants?
• New or old medication that may affect their blood pressure?
Does the patient take more than 5 medications of any sort?
Does the patient report dizziness or presented following a fall/collapse?
INTERVENTIONS Initial if appropriate for patient
Liaise with Medical Officer (MO) or Pharmacist for review of medication associated with falls.
If reporting dizziness, check lying/standing blood pressure. If a postural drop >20mmHg systolic or >10mmHg
diastolic present, discuss plan of care with MO.
Educate patient to stand up slowly and wait until dizziness resolves before mobilising. If dizziness persists,
discuss plan of care with MO.
COGNITIVE STATE RISKS Does the patient have: If risk identified initial box
Previous delirium or known diagnosis of dementia?
New or worsening memory impairment, confusion or disorientation?
Drowsiness, is easily distracted, withdrawn or depressed?
INTERVENTIONS Initial if appropriate for patient
Establish a baseline cognitive screen eg Abbreviated Mental Test (AMT).
If result abnormal (e.g. AMT <8) refer to OT or MO for prompt review.
Remain in attendance at all times when the patient is toileting or showering as this is a high risk activity for the
patient.
If agitated commence behaviour observation chart to assist behaviour management plan.
Avoid use of bedrails due to climbing/entrapment risk and consider low-low bed.
Set an alarm system in place to alert when patient is trying to get up unaided.
Re-orientate patient and ask family to assist in orientating and settling patient.
Increase frequency of patient checks to pro-actively attend to patient needs.
CONTINENCE/ELIMINATION RISKS Does the patient: If risk identified initial box
Require assistance with toileting?
Have constipation, urinary or faecal frequency/urgency or nocturia?
INTERVENTIONS Initial if appropriate for patient
Monitor/record toileting needs to check frequency, retention or constipation. Use site specific documentation.
Review toileting needs with patient daily including frequency, patients requirement for
continence/ toileting aids and assistance required to access toilet facilities.
Complete urinalysis. If abnormal, discuss with MO if MSU indicated.
PATIENT REQUIRES INTERVENTIONS OTHER THAN ABOVE (SEE PAGE 4)

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Legal entity: Health Careers International Pty Ltd. | ACN: 106 800 944 | ABN: 59 106 800 944 | RTO ID: 21985 | CRICOS Provider Code: 03386G

Education for Employment

 Falls Risk Assessment and
Management Plan (FRAMP)

MINIMUM INTERVENTIONS
To be implemented for ALL patients as appropriate
• Provide ongoing orientation for patient to bed area, toilet facilities and ward.
• Demonstrate the use of call bell, ensure it is in reach and that they can use it effectively.
• Ensure frequently used items including mobility aids are within easy reach of patient.
• Encourage patient to use their aids such as glasses or hearing aids.
• Adjust bed and chair to appropriate height for patient.
• Minimise prolonged bed-rest as it contributes to negative cardiovascular and muscle effects that may lead to falls.
• Place IV pole and all other devices/attachments on exit side of bed.
• Remove clutter and obstacles from room.
• Provide adequate lighting according to patient activities/needs.
• Encourage patient to take adequate fluids and nutrition.
• Optimise footwear where possible- discourage walking in socks/compression stockings or ill-fitting footwear.
• Bare feet (if there is no infection risk) and non-slip socks are acceptable.
• Educate that all inpatients are at increased risk of falling due to injury / illness / medications.
SHIFT BY SHIFT CHECK
If the patient has had a FALL or MEDICAL CONDITION CHANGE or WARD TRANSFER re-screen on page 1
Instructions:
Please date and initial below to confirm which interventions are implemented each shift.
DATE DATE DATE DATE DATE DATE DATE
Week 1
AM PM ND AM PM ND AM PM ND AM PM ND AM PM ND AM PM ND AM PM ND
Minimum
Interventions
ONLY OR
Minimum AND
Individualised
Interventions
DATE DATE DATE DATE DATE DATE DATE
Week 2
AM PM ND AM PM ND AM PM ND AM PM ND AM PM ND AM PM ND AM PM ND
Minimum
Interventions
ONLY OR
Minimum AND
Individualised
Interventions
DATE DATE DATE DATE DATE DATE DATE
Week 3
AM PM ND AM PM ND AM PM ND AM PM ND AM PM ND AM PM ND AM PM ND
Minimum
Interventions
ONLY OR
Minimum AND
Individualised
Interventions
DATE DATE DATE DATE DATE DATE DATE
Week 4
AM PM ND AM PM ND AM PM ND AM PM ND AM PM ND AM PM ND AM PM ND
Minimum
Interventions
ONLY OR
Minimum AND
Individualised
Interventions

Version 1 October 2023 Page 3 of 4

Legal entity: Health Careers International Pty Ltd. | ACN: 106 800 944 | ABN: 59 106 800 944 | RTO ID: 21985 | CRICOS Provider Code: 03386G

Education for Employment

 Falls Risk Assessment and
Management Plan (FRAMP)

OTHER INDIVIDUALISED INTERVENTIONS

Document other individualised interventions below.
Interventions can be added by any member of the multidisciplinary team when discussed with the
nurse in charge of care – e.g. Nurses, Allied Health, Medical Officer, Pharmacists

Date actioned and

Name and Designation Date Intervention Date ceased and by whom
by whom

COMMUNICATION AND INFORMATION TO PATIENTS AND CARERS

This section is for patients identified at risk of falls.

At each screen provide updated information about the risks for falling and plan care in partnership with patient and carer. If unable to discuss e.g.
confused/low GCS and no carer, then tick unable.

Date Discussed Staff Member Name Staff Member Signature Whom Falls Risk Was Discussed With

Initial Screen ☐ Patient ☐ Carer ☐ Unable

Re-Screen 1 ☐ Patient ☐ Carer ☐ Unable

Re-Screen 2 ☐ Patient ☐ Carer ☐ Unable

Important Practice Points

These patients need particular care managing their falls risk.

• Patients on anticoagulant, antiplatelet therapy and/ or patients with a known coagulopathy are at an increased risk of intracranial haemorrhage from
falls.

• Alcohol dependent persons, people with liver disease and people with bleeding disorders are considered coagulopathic.

• NB. Refer to local post-fall management procedure for more information.

• Patients who are known to be osteoporotic or who have suffered low trauma fractures in the past are at increased risk of sustaining a fracture even
from mild falls.

• Consider discussing with the team, vitamin D supplementation (Cholecalciferol 1000units/day) for those patients with longer lengths of stay, vitamin
D level < 60nmol/L or whom reside in residential care.

Version 1 October 2023 Page 4 of 4

Legal entity: Health Careers International Pty Ltd. | ACN: 106 800 944 | ABN: 59 106 800 944 | RTO ID: 21985 | CRICOS Provider Code: 03386G

Education for Employment