Fall prevention in hospitals isn’t about eliminating all fall risks but mitigating them to decrease incidents and improve patient safety outcomes. To accomplish this, safety teams must understand when, where, and why falls happen.
The key is to access and utilize comprehensive risk assessment tools. From there, teams must collect data and use it to inform ongoing decision-making and education opportunities.
American Data Network has created a free Fall Prevention Calculator based on the Morse Fall Scale that is simple and quick to use to evaluate the risk of a patient falling while also providing suggested interventions based on a specific patient’s risk factors.
Why Fall Prevention in Hospitals Matters
Falls are a potentially catastrophic complication of inpatient care and a big piece of evaluating patient safety. More than a third of inpatient falls result in an injury that can include fractures and head trauma. Even falls that do not result in an injury can cause stress and anxiety to the patient.
In addition to patient risk, there is also a financial risk. The Centers for Medicare and Medicaid Services does not reimburse hospitals for additional costs associated with patient falls. Aside from analyzing patient safety data to determine fall causes, there is a straightforward tool that can minimize patient falls from even happening. This is the Morse Fall Scale calculator.
What Is The Morse Fall Risk Scale?
The Morse Fall Scale (MFS) is an evidence-based fall prevention evaluation that is a quick and efficient way to assess the risk factors of a patient falling. There are six easy-to-answer questions that will rapidly identify if a fall risk is high, moderate, or low. It can also inform you if there is no fall risk present.
Not all falls are predictable or preventable in acute care settings. The MFS aid has been shown to predict up to 78% of patients who fall. According to Janice M. Morse, the researcher and creator of the MFS, falls are classified into 3 types:
- 8% are considered accidents
- 14% are due to changes in the patient’s condition and are not easily foreseeable
- 78% are anticipated physiologically and related to the condition of the patient
Benefits of Using a Morse Fall Scale
The Morse Fall Risk Assessment tool is efficient and produces consistent results. This can be helpful when standardizing the tool across facilities or hospital systems. In addition to being easy for front-line staff members to use, it also provides accurate, evidence-based results.
How the Morse Fall Scale Works
The steps involved in using the Morse Fall Scale calculator are as follows:
Data Collection: Clinicians input non-identifiable patient data through a series of dropdown selections. This data includes the patient’s history of falling, presence of secondary diagnoses, type of ambulatory aid used, IV therapy status, gait, and mental status.
Scoring Each Input: The calculator then assigns scores to each input based on established criteria:
- History of Falling: “Yes” = 25 points.
- Secondary Diagnoses: “Yes” = 15 points.
- Ambulatory Aid: “None/Bedrest” = 0 points, “Crutches/Cane/Walker” = 15 points, “Furniture” = 30 points.
- IV Therapy: “Yes” = 20 points.
- Gait: “Normal” = 0 points, “Weak” = 10 points, “Impaired” = 20 points.
- Mental Status: “Normal” = 0 points, “Forgets Limitations” = 15 points.
Total Score Calculation: The calculator sums up the points from each category to derive a total fall risk score.
Risk Level Determination: Based on the total score, the calculator categorizes the patient’s fall risk level:
- 0-24 points: Low risk.
- 25-45 points: Medium risk.
- Above 45 points: High risk.
The Morse Fall Scale Improved
ADN built an easy to use, mobile friendly Fall Prevention Calculator to place proactive fall prevention and strategic care planning at your fingertips. This fall prevention calculator builds on the Morse Fall Scale by identifying suggested interventions based on a clinicians’ answers to the Morse Fall Scale for that patient.
Adaptable and responsive, our calculator ensures optimal functionality across all devices – be it at a workstation or on a phone on the floor. This universal design guarantees that an accurate fall risk assessment and reminder of appropriate interventions is always within reach.
Need similar custom tools like this? Contact our team. We love to help teams elevate and innovate patient care. >>
How ADN’s Fall Prevention Calculator Builds on the Morse Fall Scale
Depending on the areas of risk for each patient, there are tried-and-true best practices that most clinicians know. However, if patient safety and risk management has taught us anything, it’s that best practices help prevent human error. ADN’s Fall Prevention Calculator helps ensure that patient-specific, timely reminders of appropriate interventions are suggested every time, not almost every time.
Suggestion Generation Process:
Based on Selections: For each category where the user selects an option other than the default (e.g., “Yes” for history of falling), the calculator suggests targeted interventions.
Type of Suggestions: These suggestions include measures like implementing safety precautions, considering physical therapy consults, establishing a toileting/rounding schedule, and placing the patient in a visible location.
Display of Suggestions: The suggested interventions are displayed under the corresponding risk category, providing a comprehensive guide for fall prevention tailored to the patient’s specific needs.
For the best outcomes, the calculator must be implemented into daily healthcare routines. All healthcare personnel should receive training on the effective use of the calculator and the resulting score.
Integrating the Fall Prevention Calculator into Clinical Practice
It is important to note that the Fall Prevention Calculator is a tool, not a comprehensive solution. It should be used in collaboration with other fall prevention strategies in hospitals. Ideally, care teams will implement a patient’s risk score into broader fall prevention plans.
Before implementation, patient safety teams should assess their current fall prevention strategies. Many hospitals post fall risk signs or ask patients to wear fall risk wristbands. While these are good tools to inform, they do not address the systemic errors that lead to falls in the first place.
To best utilize the Morse Fall Scale data, safety teams must first ask themselves when and why falls are happening. A Patient Safety Event Reporting application is key to recording and abstracting data. Ultimately, you will have a broad overview of trends, which can inform the necessary changes to routines and procedures.
Likewise, implementing a Near Miss or Good Catch Program can help gather qualitative data that paints a picture of systemic deficits.
About ADN
For more than 25 years, American Data Network (ADN), which is also the parent company to its Patient Safety Organization (ADNPSO), has worked with large data sets from various sources, aggregating, and mining data to identify patterns, trends, and priorities within the clinical, financial, quality and patient safety arenas. ADN developed a Patient Safety Event Reporting application, with which hospitals, clinics, rehabs, and other providers record and manage patient safety events.
By entering events into ADN’s event reporting application and submitting them to ADNPSO, information is federally protected and thereby privileged and confidential. These protections provide a safe harbor to learn from mistakes and improve patient safety.
Resources:
- Patient Safety Network, Patient Safety Primer – Falls
- Preventing Falls in Hospitals, AHRQ
- https://networkofcare.org/library/Morse%20Fall%20Scale.pdf
