Run Stop and Watch Early Warning Tool — Free

Resident & Reporter Identification

Resident Name critical (required)

Full name of the resident being observed.

Room / Bed Number critical (required)

Resident's current room and bed assignment.

Date and Time of Observation critical (required)

When the change was first noticed.

Staff Member Completing This Report critical (required)

Name and title of the CNA or frontline staff member completing this tool.

Shift critical (required)

Shift during which the change was observed.

S — Seems Different Than Usual

Resident seems different than usual today critical (required)

A general, non-specific change from the resident's normal baseline — even if you cannot pinpoint exactly what is wrong. Trust your instinct.

Yes No N/A

Note (optional)

Describe what seems different (if Yes above)

Provide a brief, specific, observable description of what is different from the resident's normal baseline.

T — Talked or Communicated Less Than Usual

Resident talked or communicated less than usual critical (required)

Noticeable decrease in verbal output, responsiveness to questions, or social engagement compared to the resident's normal communication pattern.

Yes No N/A

Note (optional)

Resident appears confused, disoriented, or less alert than usual critical (required)

New or worsening confusion, difficulty following conversation, or decreased level of alertness — a potential sign of acute change in mental status.

Yes No N/A

O — Overall Needs More Help Than Usual

Resident needed more help with ADLs than usual (bathing, dressing, grooming, toileting)

Required more staff assistance or prompting than is documented in the resident's current care plan baseline.

Yes No N/A

Resident had difficulty walking, transferring, or had increased fall risk compared to usual critical (required)

New unsteadiness, weakness, or reluctance to bear weight that differs from the resident's established mobility baseline.

Yes No N/A

Resident stayed in bed or chair more than usual / did not want to get up

Unusual inactivity, withdrawal from normal routines, or reluctance to participate in scheduled activities.

Yes No N/A

P — Pain, Discomfort, or Physical Symptoms

Resident complained of or showed signs of new or worsening pain critical (required)

Verbal complaint of pain, or non-verbal signs such as grimacing, guarding, moaning, or reluctance to move.

Yes No N/A

Note (optional)

Resident had new or worsening shortness of breath, labored breathing, or coughing critical (required)

Any change in respiratory pattern, rate, or effort compared to the resident's normal baseline.

Yes No N/A

Resident had new skin changes (redness, swelling, wound, rash, or bruising) critical (required)

Any new skin breakdown, pressure injury, unexplained bruising, or rash not previously documented.

Yes No N/A

Photo evidence (optional)

Resident had new or worsening nausea, vomiting, or diarrhea

Any GI symptoms not present at the prior assessment or worsening beyond the resident's known baseline.

Yes No N/A

Resident ate or drank less than half of their meal / refused food or fluids

Significant reduction in oral intake compared to the resident's normal eating pattern.

Yes No N/A

Escalation & Nurse Notification

Were any 'Yes' responses identified in this assessment? critical (required)

Summary flag: if any changes were noted above, nurse notification is required.

Yes No N/A

Nurse notified of findings critical (required)

Confirm that the nurse has been verbally notified of the observed changes documented in this report.

Yes No N/A

Name of Nurse Notified critical (required)

First and last name of the nurse who received this report.

Time Nurse Was Notified critical (required)

Time the verbal or written notification was made to the nurse.

Method of Notification

How the nurse was informed of the observed changes.

Additional Notes or Context for the Nurse

Any additional observations, context, or relevant history that may help the nurse assess the resident's condition.

Staff Signature critical (required)

Signature of the CNA or frontline staff member completing this Stop and Watch report.

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Run: Stop and Watch Early Warning Tool

Resident & Reporter Identification

S — Seems Different Than Usual

T — Talked or Communicated Less Than Usual

O — Overall Needs More Help Than Usual

P — Pain, Discomfort, or Physical Symptoms

Escalation & Nurse Notification

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