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Re-evaluating the Morse Fall Scale in obstetrics and gynecology wards and determining optimal cut-off scores for
Bijun Mao1, Huiping Jiang1, Yan Chen1
1Nursing Department, Huzhou Maternity & Child Health Care Hospital, Huzhou, China.
Objective:
This study aims to examine the validity of the MFS by analyzing the electronic medical records on fall risk in obstetrics and gynecology wards and determine the optimal cut-off score of the Morse Fall Scale.
Design:
A retrospective survey.
Methods:
The research was conducted in an Obstetrics and Gynecology Hospital and a general hospital. The sample included 136 fall inpatients and 120 no-fall inpatients recruited from January 1st, 2020, to July 10th, 2022. The Morse Fall Scale was analyzed using the gold standard of patients who fell while hospitalized, assessing the area under the Receiver Operating Characteristic curve, sensitivity, specificity, accuracy, positive predictive value, negative predictive value, and Kappa.
Results:
At cut-off scores of 40, 45,50, and 55, the area under the Receiver Operating Characteristic curve was 0.772, 0.761, 0.749, and 0.763, respectively. The Youden index was 0.543, 0.521, 0.498, and 0.525, while Kappa values were 0.540, 0.518, 0.490, and 0.515. Sensitivity was 0.735, 0.713, 0.640, and 0.625; specificity was 0.808, 0.808, 0.858, and 0.900. The positive predictive values were 0.813, 0.808, 0.837, and 0.876, and the negative predictive values were 0.729, 0.713, 0.678, and 0.679. Accuracy were 0.770, 0.758, 0.742, and 0.754.
Conclusions:
The Morse Fall Scale demonstrates good predictive performance for assessing fall risk in gynecology and obstetrics wards. The optimal cut-off score is 40.
Insights
The Morse Fall Scale effectively predicts fall risk in obstetrics and gynecology wards. An optimal cut-off score of 40 demonstrates good predictive performance for patient safety.
Area of Science:
- Medical Sciences
- Nursing Research
- Patient Safety
Background:
- Falls in healthcare settings pose significant risks, particularly in obstetrics and gynecology wards.
- Accurate fall risk assessment tools are crucial for implementing timely preventive measures.
- The Morse Fall Scale (MFS) is widely used but requires validation in specific patient populations.
Purpose of the Study:
- To evaluate the validity of the Morse Fall Scale (MFS) in obstetrics and gynecology settings.
- To determine the optimal cut-off score of the MFS for predicting fall risk in these wards.
- To analyze the predictive performance of the MFS using electronic medical records.
Main Methods:
- A retrospective survey design was employed.
- Data were collected from 136 fall inpatients and 120 no-fall inpatients across two hospitals.
- The Morse Fall Scale's performance was assessed using Receiver Operating Characteristic (ROC) curve analysis, sensitivity, specificity, and accuracy.
Main Results:
- The area under the ROC curve ranged from 0.749 to 0.772 across different cut-off scores.
- At a cut-off score of 40, the MFS demonstrated a sensitivity of 0.735 and a specificity of 0.808.
- The optimal cut-off score of 40 yielded the highest Youden index and good overall predictive accuracy.
Conclusions:
- The Morse Fall Scale (MFS) exhibits good predictive performance for fall risk assessment in obstetrics and gynecology wards.
- A cut-off score of 40 is identified as optimal for enhancing the scale's utility in these clinical settings.
- These findings support the use of the MFS with a cut-off of 40 for improved patient safety.
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