Falls in Acute Care Patients-Exploring the Predictive Value of the Morse Fall Scale: A Retrospective Analysis.

BACKGROUND

Falls among hospitalized patients are a substantial cause of adverse health outcomes, making prevention efforts an important priority. The Morse Fall Scale (MFS) is a popular tool to assess fall risk, although its predictive usefulness is limited in certain health care settings.

PURPOSE: We aimed to explore the predictive value of the MFS, as well as additional factors associated with falls in acute care settings.

METHODS

This retrospective analysis included data from 4,887 adult patients 18 years of age and older stored in the repository of an acute care inpatient hospital. Data were analyzed using multivariate regression models and area under the receiver operating characteristic curves to determine the validity of the MFS as a predictor of falls.

RESULTS

Of the 4,887 patients admitted to the acute care hospital setting, 343 (7%) experienced a fall. The median age of the cohort was 70.9 years. After propensity score matching, MFS scores did not differ significantly between those who experienced falls and those who did not. Several variables, such as All Patient Refined Diagnosis Related Group severity, environmental factors, unsteady gait, low bowel continence level, lack of alertness, skin moisture status as either dry or moist, benzodiazepine administration, diabetes, previous drug use, discharge status documented in the electronic health record, sepsis, atrial fibrillation, and hospitalization duration, were significantly associated with a greater risk of falls.

CONCLUSIONS

The MFS did not adequately predict falls. Several additional factors were associated with a greater risk of falls. Nurses and other clinicians should incorporate these insights into fall prevention protocols. These findings warrant inclusion in fall risk assessment guidelines, protocols, and fall prevention training programs.