Run Bed and Chair Alarm Equipment Check — Free

Inspection Setup

Inspection date and time

Record the date and time this check is being performed.

Inspector name and role

Enter the full name and job title of the staff member performing this check (e.g., CNA, RN, Charge Nurse).

Unit / Ward / Room range covered

Specify the unit, ward, or range of room numbers included in this inspection (e.g., 'East Wing, Rooms 101–120').

Shift

Select the shift during which this inspection is being conducted.

Bed Alarm — Physical Condition and Setup

Bed alarm unit is present and assigned to the correct patient bed critical (required)

Confirm the alarm device is physically present at the bed and matches the care plan order for this patient. Missing or misassigned alarms constitute a critical deficiency.

Yes No N/A

Sensor pad / pressure mat is free of visible damage (no tears, cracks, or fraying) critical (required)

Inspect the sensor pad or pressure-sensitive mat for physical damage that could cause false negatives (alarm fails to trigger when patient moves).

Yes No N/A

Sensor pad is correctly positioned under patient (per manufacturer placement guide) critical (required)

Confirm pad is centered under the patient's torso/hips as specified by the manufacturer. Incorrect placement is a leading cause of missed activations.

Yes No N/A

Connecting cable / cord between sensor and alarm unit is intact and securely plugged in

Check for kinks, cuts, or loose connections at both the sensor and alarm unit ends.

Yes No N/A

Alarm unit is positioned where staff can clearly hear activation from the hallway

The alarm must be audible at the nursing station or in the corridor. Confirm placement is not muffled by bedding, curtains, or furniture.

Yes No N/A

Bed Alarm — Functional Test

Alarm activates within ≤ 3 seconds of sensor pad weight removal (simulated exit) critical (required)

Briefly lift or simulate removal of patient weight from the sensor pad. Alarm should sound within 3 seconds. Record actual response time if delayed.

Yes No N/A

Alarm volume is audible at ≥ 65 dB at the room doorway critical (required)

Verify alarm tone is loud enough to alert staff in the corridor. If a decibel meter is unavailable, confirm audibility from the doorway and document method used.

Yes No N/A

Alarm resets correctly and silences when patient weight is restored to sensor pad

Confirm the alarm stops and resets to armed/active state when weight is reapplied. Failure to reset may indicate a faulty unit.

Yes No N/A

Power source status

Select the current power source for this alarm unit.

Battery level (if battery-powered) — percentage or indicator status

If the unit uses batteries, record the battery level shown on the display or indicator light. Replace if below manufacturer-recommended threshold (typically < 20%).

Chair Alarm — Physical Condition and Setup

Chair alarm unit is present and assigned to the correct patient / chair critical (required)

Confirm the device is physically present and matches the care plan order. A missing chair alarm for a high-fall-risk patient is a critical deficiency.

Yes No N/A

Sensor pad / cushion is free of visible damage (no tears, cracks, or fraying) critical (required)

Inspect the chair sensor pad for physical damage that could impair activation.

Yes No N/A

Sensor pad is correctly positioned on chair seat per manufacturer instructions

Pad should be centered on the seat surface with the connector oriented as specified. Misplacement can cause missed activations or false alarms.

Yes No N/A

Connecting cable / cord is intact and securely attached to alarm unit

Check for damage, kinks, or loose connections along the full length of the cable.

Yes No N/A

Chair Alarm — Functional Test

Alarm activates within ≤ 3 seconds of sensor pad weight removal (simulated patient rise) critical (required)

Briefly lift or simulate removal of patient weight from the chair sensor pad. Alarm should sound within 3 seconds.

Yes No N/A

Alarm volume is audible at ≥ 65 dB at the room or area doorway critical (required)

Verify the alarm tone is loud enough to alert staff. Document method of verification if a decibel meter is not used.

Yes No N/A

Alarm resets correctly and silences when patient weight is restored to sensor pad

Confirm the alarm stops and returns to armed state when weight is reapplied.

Yes No N/A

Power source status

Select the current power source for this chair alarm unit.

Deficiencies, Corrective Actions, and Sign-Off

Total number of alarm units inspected this check

Enter the total count of bed and chair alarm units checked during this inspection session.

Number of units with deficiencies identified

Enter the count of units that failed one or more inspection items. Enter 0 if all units passed.

All deficient units have been removed from service or replaced pending repair critical (required)

Confirm that any alarm unit that failed a critical check has been taken out of service and a replacement has been placed or the patient's care plan has been updated with an alternative fall prevention intervention.

Yes No N/A

Deficiency details and corrective actions taken

Describe each deficiency found (room number, unit type, nature of failure) and the corrective action taken or escalation initiated. Write 'None' if no deficiencies were found.

Charge nurse / supervisor notified of any critical deficiencies

If any critical items failed, confirm that the charge nurse or supervisor was notified before end of check.

Yes No N/A

Inspector signature

Sign to certify that all items in this inspection were completed accurately and any deficiencies have been documented.

Get your results

Enter your email — we'll send you a PDF of your filled-out template, plus the occasional MangoScoop newsletter (templates, workflow tips, product updates). Unsubscribe anytime — link is in every email.

Email (required)

Your name (optional)

Run: Bed and Chair Alarm Equipment Check

Inspection Setup

Bed Alarm — Physical Condition and Setup

Bed Alarm — Functional Test

Chair Alarm — Physical Condition and Setup

Chair Alarm — Functional Test

Deficiencies, Corrective Actions, and Sign-Off

Get your results