Page 18 - FALL GUIDELINES MOH 2019

3.0 SCREENING

FALLS RISK ASSESSMENT TOOLS

A number of falls risk assessment tools have been developed and tested in different clinical
settings. These tools help identify older adults who are at risk of falls and facilitate steps to
prevent them. Reliable fall risk assessment tools are important in order to predict risk of
falls as accurately as possible. However, these tools need to be applied with clinical
judgment and assessment needs to be individualized.

The most important role of an assessment tool is to identify fall risk factors for which care
plans can be developed. Examples are the:
 Morse Fall Scale
 Hendrich II Falls Risk Model
 Schmid Falls Risk Assessment Tool
 St. Thomas’s Risk Assessment Tool (STRATIFY)

The Morse Falls Scale (Refer to Appendix 1)

Several studies have shown the benefits of using the Morse Falls Scale over other tools due
to its high positive predictive value in predicting fallers and its suitability for use in hospital.

The Morse Falls Scale identifies the risk of falling in hospitalized patients and care plans can
be modified to address this risk.

Advantages of the Morse Falls Scale are:
 A rapid and simple method of assessing an older adult’s likelihood of falling
 Requires less than 3 minutes to be completed
 Has good predictive validity and interrater reliability
 Widely accepted and used in acute care settings

It should be noted that Morse herself stated that the appropriate cut-off points to
distinguish risk should be determined by each institution based on the risk profile of its
patients.

15

15