Predicting Falls With the Morse Fall Scale: A Retrospective Assessment at the Veterans Health Administration.
Peter J Hoover, Terri L Blumke, Anna D Ware and 4 others
PMID 41944392WHAT IT FOUND
The Morse Fall Scale poorly identified Veterans who would fall in hospital.
Adding comorbidity and mortality scores improved prediction only slightly and still did not separate fallers well.
Key findings
01The Morse Fall Scale showed poor discrimination for predicting documented falls, with an area under the curve of 0.65 in the linear model and 0.66 in the cubic model.
02Adding Care Assessment Need, Charlson Comorbidity Index and demographics raised the area under the curve to 0.7, but the model still had poor precision at 5.8%.
03Half of the sample was classified as High Risk, and fall incidence was 2.1% in Low Risk, 1.8% in Moderate Risk, and 4.7% in High Risk.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The study looked back at electronic records and could not control for whether staff knew the Morse score and changed care because of it. It used VHA acute care data, a sample that was 92.6% male with average age 66.9 years, so results may not apply to other patient groups. Individualized fall prevention interventions were not captured or documented consistently, so the study could not fully evaluate how care was delivered. Only one Morse score per stay was analysed, so changes during the stay may be missed. Patients without a documented Morse score or with incomplete Care Assessment Need or Charlson Comorbidity Index scores were excluded.
Declared interests
The authors reported no financial support for the research, authorship, or publication, and no potential conflicts of interest.
The easy way to misread this
Do not conclude that adding the Care Assessment Need and Charlson Comorbidity Index scores makes the Morse Fall Scale clinically reliable. The paper reported poor precision at 5.8%, and the study did not test whether the improved model changed fall outcomes.