Background and Purpose: Falls are a serious incident impacting patient safety, quality of healthcare delivery and overall hospital outcomes. Each year in the United States, approximately 700,000 to one million patients experience a fall in the hospital setting (Currie, 2008). The neuroscience population is known to have the highest fall rates of any population (Hester & Davis, 2013). Tracked by agencies such as the Joint Commission (TJC) and National Database for Nursing Quality Indicators (NDNQI), falls are an indicator of hospital performance and have a significant financial impact; falls with patient injury increase length of stay and thousands of dollars in increased, non-reimbursed hospital costs. One of the biggest challenges in fall prevention is utilizing the appropriate instrument to accurately identify patients at high risk for falling. The purpose of this retrospective study is to investigate the accuracy of predicting falls of the validated Morse Fall Scale (MFS) in a mixed neuroscience unit.
Methods: Retrospective data was collected on patients admitted to the neuroscience unit for a 6 month period (May 1, 2014 to December 1, 2014) to determine the incidence of falls, faller types and evaluate the MFS predictive ability. In total, 80 patient charts were reviewed, 40 patients who fell within the specified time frame were matched to 40 patients who did not fall during the hospitalization. Demographics included age, gender, Morse Fall Score (MFS) immediately prior to fall.
Results: 30% of the fallers and the non-fallers were women with a mean age of 66 for fallers and 66.4 for non-fallers. The mean MFS for fallers 58.4 was and non-fallers was 41.1. A Wilcoxon rank test showed a significant difference in the median scores between the fallers and the non-fallers (z = 3.975, p < 0.001), the fallers having a higher median score than the non-fallers. With the suggested scores for the Morse scale as:
Conclusions: The MFS has adequate screening qualities, however a higher specificity is desirable. Due to inconsistency of MFS scores by the end- users (staff nurses) and upon further review of past and current fall literature, the neuroscience population would benefit from further research to further examine the specificity, sensitivity and variability of fall risk assessments; this would greatly impact patient safety and influence quality of care provided.
11th Annual BHSF Research Conference
Baptist Health South Florida Affiliations:
Bridget Webster, MS, RN, ACNS-BC
Webster, Bridget, "Fall Management in a Mixed Neuroscience Unit: The Predictive Ability of the Morse Fall Scale" (2016). All Publications. 2690.
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