Beyond the score: Reevaluating the Morse Fall Scale for fall risk assessment among hospitalized veterans

Area of Science:

• Healthcare research
• Patient safety
• Clinical assessment tools

Background:

• Inpatient falls lead to significant patient harm and healthcare costs.
• The Morse Fall Scale (MFS) is a common tool for assessing fall risk in hospitals.
• The MFS's effectiveness in distinguishing between high-risk and low-risk fallers is uncertain.

Purpose of the Study:

• To determine if the admission Morse Fall Scale (MFS) total score or its individual components can differentiate between inpatients who fall and those who do not.
• To identify specific MFS categories or patient characteristics associated with inpatient falls.

Main Methods:

• Retrospective cohort study including 5004 inpatients with MFS assessments upon admission (June 2022 - May 2024).
• Fall occurrence was documented through post-fall records.
• Statistical analyses included group comparisons and logistic regression to identify fall predictors.

Main Results:

• 3.5% of patients experienced falls.
• Patients who fell had significantly higher MFS total scores than non-fallers, with both groups exceeding the high-risk threshold (≥45).
• Predictors of falls included prior fall history, impaired mental status, use of assistive devices, and gait abnormalities.

Conclusions:

• The MFS total score may lack utility in differentiating fall risk among inpatients.
• Specific risk factors like fall history, mental status, assistive device use, and gait impairment are strongly associated with falls.
• Individualized interventions targeting specific high-risk characteristics are recommended for effective fall prevention in acute care settings.