Page 64 - MALAYSIAN PATIENT SAFETY GOALS

ROLES AND RESPONSIBILITIES OF NURSES

1. To conduct Continuous Nursing Education and Continuous
Medical Education regarding awareness of falls to all unit,

department and hospital level.
2. Education and training
- Mentor - mentee program.

- Orientation program for new staffs.
3. Pre Fall
Patient Assessment

- Assessment of patient on admission using the Morse
Fall Scale.
- Put proper signage on patient’s bed based on Fall Risk

Assessment Score

Fall Risk Assessment Score

(i) No risk – Score 0 - 24 (No signage)
(ii) Low risk – Score 25 - 44 (Yellow signage)
(iii) High risk – Score > 45 (Red signage)

4. Patients who are at high risk ( red signage ) and low risk
(yellow signage ) should be placed in cot bed with side railing

up and placed near the nursing counter.
5. Risk assessment of the patient should be done whenever
necessary.

6. Orientation and health education will be given to patient and
family/ relatives :
- Predisposing factors that lead to fall

- Prevention of fall.
- Allow family member to accompany patient in the ward

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