Patient Falls

Definition: A fall occurs when a person unintentionally comes to rest on the ground or below their initial level.

Literature review

The results of a recent study of nine (9) participating hospitals by Krauss et al. (2007) found:

A study published in 2004 by Hitcho identified 183 falls over a period of 13 weeks at a 1300 bed academic hospital. Falls in the psychiatric and physical therapy services were excluded.

Factors associated with falls identified by Krauss and Evanoff et al.:

Joint Commission (2000) reviewed root cause analysis of 22 fatal falls:

Self-Reported Falls and Fall-Related Injuries Among Persons Aged >65 Years (CDC (MMWR), 3/7/08).                 

Patient Fall Risk Assessment

Components of the Morse Fall Scale
  • History of falling
  • Secondary diagnosis (syncope, etc.)
  • Ambulatory aids
    • Physical assistance, wheelchair
    • Crutches, cane, walker
    • Furniture
  • IV tubing or access
  • Gait or transferring mobility
    • weakness
    • impairment
  • Cognitive impairment

Patient fall risk should be a integral part of the initial nursing assessment in most acute and long-term care settings. In addition, the patient's fall risk should be reassessed whenever a health status change occurs.

The Morse Fall Scale (MFS) is a popular fall risk assessment tool. The MFS has been validated in a number of settings and has been found to be most useful when the intervention cut-off values are adjusted to reflect the fall rate in a particular care setting.

The American Geriatrics Society suggests the “Get Up and Go Test” as an assessment tool for any older person who has experienced a fall. It is a brief test used to identify "at risk" patients who need further evaluation. When you are prepared to break a potential fall, ask your patient to:

Fall reduction resources