Risk assessment and incidence of falls in adult hospitalized patients

cohort study, with approval by the Research Ethics Committee, which monitored 831 patients hospitalized at a university hospital. The Morse Fall Scale (MFS) was used to assess the risk and patients with high risk (≥45 points) were considered exposed to falls.

Results:

the mean MFS score was 39.4 (±19.4) points. Between the first and the final assessment, the score increased by 4.6%. The first assessment score presented a strong and positive correlation with the final assessment score (r=0.810; p=0.000).

Conclusion:

the higher the risk score for falls when the patient is admitted, the higher the score at the end of the hospitalization period and vice-versa. The incidence rate corresponded to 1.68% with a higher percentage of patients classified at high risk of falls.

Descriptors:
Nursing; Accidental Falls; Patient Safety; Scales; Hospitalization; Incidence

Escola de Enfermagem de Ribeirão Preto / Universidade de São Paulo Av. Bandeirantes, 3900, 14040-902 Ribeirão Preto SP Brazil, Tel.: +55 (16) 3315-3451 / 3315-4407 - Ribeirão Preto - SP - Brazil
E-mail: rlae@eerp.usp.br

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[1] Corresponding Author: Tânia Solange Bosi de Souza Magnago Universidade Federal de Santa Maria. Centro de Ciências da Saúde Av. Roraima, 1000 Bairro: Camobi CEP: 97105-900, Santa Maria, RS, Brasil E-mail: tmagnago@terra.com.br

Morse Fall Scale (MFS)	N	Minimum Score	Maximum Score	Mean	Standard Deviation
General Average*	831	0	110.0	39.4	19.4
Standard Deviation	661	0	33.44	5.3	6.4
Variation Coefficient	649	0	0.185	0.177	0.296

Item Morse Fall Scale (MFS)	N	%
History of falls
Yes	203	24.4
No	628	75.6
Secondary Diagnosis
Not more than one medical diagnosis	325	39.1
More than one medical diagnosis	506	60.9
Use of intravenous device
Yes	771	92.8
No	60	7.2
Help with walking
None; Totally bedridden; Help by Health Professional	710	85.4
Uses Crutches/Cane/Walker	53	6.4
Holds on to Furniture/Wall	68	8.2
Walking
Normal; Does not walk/ Totally bedridden/ Uses Wheelchair	411	49.5
Weak	258	31.0
Committed/ staggering	162	19.5
Mental Status
Oriented in terms of capacity/limitation	760	91.5
Overestimates capacity/ Forgets limitations	71	8.5

Classification of risk for falls - Morse Fall Scale (MFS)	N	%
Morse Fall Scale (MFS) - First Assessment
Low	255	30.7
Moderate	272	32.7
High	304	36.6
Morse Fall Scale (MFS) - Final Assessment
Low	212	25.5
Moderate	277	33.3
High	342	41.2
Morse Fall Scale (MFS)- Mean assessments
Low	210	25.6
Moderate	308	37.1
High	313	37.7

Variables	Fall				p
	No		Yes
	N	%	N	%
Sex					0.838*
Female	323	97.6	8	2.4
Male	489	97.8	11	2.2
Age					0.609*
18 to 59 years	390	98.0	8	2.0
60 to 92 years	422	97.5	11	2.5
Physical exercise					0.183^†
No	603	97.3	17	2.7
Yes	209	99.1	2	0.9
Musculoskeletal Problem					0.840*
No	531	97.8	12	2.2
Yes	281	97.6	7	2.4
Visual Difficulty					0.701*
No	224	97.4	6	2.6
Yes	588	97.8	13	2.2
Hearing Difficulty					0.009†
No	676	98.4	11	1.6
Yes	136	94.4	8	5.6
Muscle Strength
Upper Limbs					0.891*
Reduced	589	97.8	13	2.2
Preserved	223	97.4	6	2.6
Lower Limbs					0.262*
Reduced	587	98.2	11	1.8
Preserved	225	96.6	8	3.4
Morse Fall Scale - Mean Assessments					<0.001^‡
Low Risk	210	100.0	--	---
Moderate Risk	307	99.7	1	0.3
High Risk	295	94.2	18	5.8
Morse Fall Scale - First Assessment					<0.001^‡
Low Risk	254	94.6	1	0.4
Moderate Risk	270	99.3	2	0.7
High Risk	288	94.7	16	5.3
Morse Fall Scale - Final Assessment					<0.001^‡
Low Risk	212	100.0	--	--
Moderate Risk	276	99.6	1	0.4
High Risk	324	94.7	18	5.3