What to include in a patient safety assessment to identify fall risks, mobility issues, and environmental hazards.

Safety isn’t a fancy word for the nurse’s locker. It’s the daily, hands-on habit that keeps patients from getting hurt. In the world of healthcare, a patient safety assessment is like a pre-emptive check-up for risk. It isn’t about guessing who might stumble later; it’s about spotting real, immediate hazards and setting things up so people can move, breathe, and heal without unnecessary obstacles. In ATI Skills Modules 3.0, the Safety Video component brings these ideas to life with scenarios that show what to look for and how teams respond. Let’s unpack what a solid safety assessment actually looks like—and why the focus on a few key areas makes all the difference.

What makes a safety check really work? The big three

If you’ve ever watched a safety video or walked through a patient’s room, you’ve probably noticed three recurring themes: falls risk, mobility issues, and environmental hazards. Yes, these surface a lot, but that’s because they touch the core of daily safety in any care setting.

• Falls risk: Think about balance, strength, dizziness, recent dizziness, and medications that can make a person feel lightheaded. A patient who has fallen before or who uses a walker or cane will need closer observation and a plan that supports safe ambulation. The goal isn’t to micromanage every second but to ensure someone is there to assist when needed and to remove slippery surprises before they happen.

• Mobility issues: Mobility isn’t just about walking. It’s about transfers (getting in and out of a chair or bed), range of motion, and the ability to change positions safely. People progress at different speeds, and it’s easy to miss a subtle limitation—like trouble shifting weight or a weak leg—until a routine move turns tricky. A good assessment notes what kinds of help the patient can tolerate, what devices might help (grab bars, transfer belts, appropriate footwear), and where extra staff or equipment are warranted.

• Environmental hazards: This is the “space around the person” part. Lighting that’s too dim, cords sprawled across a path, rugs with edges curling up, clutter in hallways, or an overly high bed can all set the stage for a stumble. Equipment left within arm’s reach of a bed—sometimes called by-the-bed hazards—needs a second look. The environment should invite safe movement, not impede it.

A quick note about why these three areas trump others in immediate safety concerns: the moment you have a fall risk, a mobility bottleneck, or an unsafe space, lots of other variables start to matter less if those aren’t addressed. A patient may have a long medical history or a certain financial status, but what makes the room safer for a walk to the bathroom is whether the path is clear, the light is adequate, and someone is there to steady them when needed. The safety assessment zooms in on what can go wrong in real time.

What you’re looking for when you assess

Here’s a practical lens you can use, inspired by how the Safety Video components illustrate real-life scenes:

• Fall risk signals:

• History of previous falls or near-falls

• Gait disturbances or unsteady balance

• Footwear that’s worn or slippery

• Dizziness, faintness, or orthostatic symptoms

• Medication side effects that affect alertness or blood pressure

• Mobility signals:

• Recent changes in strength or endurance

• Ability to transfer safely between bed, chair, and standing

• Use of assistive devices (walkers, canes, crutches, wheelchairs)

• Pain that limits movement or causes guard reactions

• Need for helper during ambulation or transfers

• Environmental signals:

• Adequate lighting in key spaces (hallways, bathroom, and room)

• Clutter-free pathways and properly placed furniture

• Secure, unobstructed call bells and reach-ability for essentials

• Floor surfaces that aren’t slick or uneven

• Bed height and rails that match the patient’s needs and abilities

The human side: teamwork and communication

A safety assessment isn’t a solo task. It works best when the patient, family, and care team share the same map. Here are a few ways to keep that map accurate and up-to-date:

• Talk with the patient: Ask how easy it is to get in and out of bed, whether they feel unsteady at certain times of day, and if they notice anything in the room that trips them up.

• Include family or caregivers: They often see patterns the clinical team might miss—like afternoon dizziness after the medication switch or a chair placement that isn’t convenient for daily routines.

• Coordinate with the team: Nursing, physical therapy, occupational therapy, and environmental services all have eyes on safety from different angles. A quick huddle can catch something one person misses.

A real-world moment

Let me explain with a simple vignette: An elderly patient in a sunny corner room uses a cane but often forgets to turn on the lights when they wake at night. A nurse notices a dim corner that’s tough to see, and there’s a loose rug near the bed. In a few minutes, the team adjusts the lighting to a brighter, more natural level, tucks the rug away or secures it, and places a night-light and call bell within easy reach. The next night, that patient makes it to the bathroom with a simple, safe stride instead of shuffling along in fear. Small adjustments, big impact.

Why this approach matters for safety outcomes

You might wonder why we bother with these details. Here’s the bottom line: when you identify fall risks, mobility issues, and environmental hazards, you’re laying the groundwork for safer ambulation, easier transfers, and fewer accidents. It isn’t about being perfect; it’s about acting early and thoughtfully. Think of it as preventing a puddle before it becomes a slip, rather than reacting after the slip.

A few realistic touchpoints to remember

• Document clearly: If something changes—weight-bearing status, a new chair for support, a new medication that affects balance—write it down. The information travels with the patient across shifts and days.

• Reassess routinely: A safety check isn’t a one-and-done thing. People heal, meds change, rooms get rearranged. A quick re-check is worth the effort.

• Personalize the plan: Some patients love a little independence; others need a steady hand. The plan should reflect the individual, not a generic checklist.

• Keep the tone calm and supportive: Fear can be a barrier to safe movement. A reassuring voice, clear instructions, and a respectful approach go a long way.

A few digressions that stay on target

Design matters as much as discipline. Hospitals aren’t just about beds and charts; they’re spaces that shape behavior. Wide corridors, color-coded zones for different care activities, and clearly marked doors reduce confusion and hesitation. Home care echoes the same principles: clear pathways, properly placed lighting, and a clutter-free living space help people stay steady even when they’re not in a clinical setting.

If you’ve ever rearranged a room at home to make it safer for an aging relative, you know the feeling—minor changes can yield big confidence gains. In clinical care, the same logic applies, just at a larger scale and with more stakeholders involved. The Safety Video scenarios you’ll encounter in ATI’s module aren’t just dramatic moments; they’re reminders that real-life safety hinges on practical, everyday choices.

Putting it all together: a simple, repeatable mindset

• Look for the three big pillars: fall risk, mobility, environment.

• Talk with the patient and their support network to capture every nuance.

• Act with intention: lighting, clutter, distance to essential items, and appropriate assistance.

• Re-check and adjust as needed; safety is a moving target, not a fixed point.

• Communicate clearly across the care team so everyone stays aligned.

A closing thought

Safety isn’t about fear; it’s about confidence. When patients feel supported—knowing someone is watching out for the little things that could trip them up—they move with more assurance. And when caregivers have a clear framework for assessing risk, they can respond quickly and effectively, which means fewer injuries and more time focused on healing.

If you’re curious about how these ideas come to life in real care environments, you’ll notice a consistent thread: the most effective safety plans are straightforward, collaborative, and adaptable. They respect the person in the bed as a whole person, not a checklist item. And as a reader who wants to understand how these pieces fit together, you’re building a strong foundation for safer care—one thoughtful assessment at a time.