Patient Elopement Prevention Checklist
Comprehensive elopement prevention assessment including risk identification, environmental safety measures, and monitoring protocols for at-risk patients.
- Industry: Healthcare
- Frequency: Per shift / Ongoing
- Estimated Time: 10-15 minutes
- Role: Nurse/Security
- Total Items: 30
- Compliance: Joint Commission Environment of Care, CMS CoP, State Regulations
Elopement Risk Assessment
Identify risk factors
- History of elopement attempts?
- Wandering behavior observed?
- Cognitive impairment present?
- Patient expressed desire to leave?
- Agitation or restlessness?
Prevention Measures
Safety interventions
- Patient properly identified (wristband)?
- Wanderguard/GPS device applied (if ordered)?
- Door alarms functional?
- Visual monitoring in place?
- Sitter assigned if needed?
Environmental Safety
Physical environment
- Exits adequately monitored?
- Unit secured appropriately?
- Current photo available?
Communication
Staff awareness
- All staff notified of elopement risk?
- Security aware of high-risk patient?
- Care plan reflects elopement risk?
Pre-Assessment Information
Initial assessment documentation and patient/facility identification
- Assessor Name / Credentials
- Assessment Date
- Department / Unit
- Assessment Type (Routine/Annual/Complaint)
- Previous assessment findings reviewed?
Infection Prevention & Control
Verify infection control practices per CDC and Joint Commission standards
- Hand hygiene compliance observed?
- Appropriate PPE available and properly used?
- Isolation precautions properly implemented?
- Sharps containers available and not overfilled?
- High-touch surfaces properly disinfected?
Patient Safety & Identification
Verify patient safety protocols and identification procedures
- Two patient identifiers used before procedures?
- Fall risk assessment completed?
- Call light within patient reach?
- Bed in lowest position with brakes locked?
Related Healthcare Checklists
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- Restraint-Free Environment Assessment Checklist
- Pediatric Early Warning Score (PEWS) Checklist
- Medical Device Incident Report Checklist
- Hospital-Acquired Condition Prevention Checklist
- Patient Rights Admission Review Checklist
- Sentinel Event Investigation Checklist
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Why Use This Patient Elopement Prevention Checklist?
This patient elopement prevention checklist helps healthcare teams maintain compliance and operational excellence. Designed for nurse/security professionals, this checklist covers 30 critical inspection points across 7 sections. Recommended frequency: per shift / ongoing.
Ensures compliance with Joint Commission Environment of Care, CMS CoP, State Regulations. Regulatory-aligned for audit readiness and inspection documentation.
Frequently Asked Questions
What does the Patient Elopement Prevention Checklist cover?
This checklist covers 30 inspection items across 7 sections: Elopement Risk Assessment, Prevention Measures, Environmental Safety, Communication, Pre-Assessment Information, Infection Prevention & Control, Patient Safety & Identification. It is designed for healthcare operations and compliance.
How often should this checklist be completed?
This checklist should be completed per shift / ongoing. Each completion takes approximately 10-15 minutes.
Who should use this Patient Elopement Prevention Checklist?
This checklist is designed for Nurse/Security professionals in the healthcare industry. It can be used for self-assessments, team audits, and regulatory compliance documentation.
Can I download this checklist as a PDF?
Yes, this checklist is available as a free PDF download. You can also use it digitally in the POPProbe mobile app for real-time data capture, photo documentation, and automatic reporting.