Evaluation of Morse Fall Scale in hospitalised patients

Institute of Nursing Science, University of Basel, Basel, Switzerland.
Age and Ageing (Impact Factor: 3.64). 06/2006; 35(3):311-3. DOI: 10.1093/ageing/afj066
Source: PubMed
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Available from: Sabina De Geest, Nov 11, 2015
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    • "Pre-operative indication of the use of coupling with a different type of acetabular component was as follows: a traditional cup in patients under 80 not showing co-morbidity with pre-fracture unaided walking; a bipolar cup for patients over 80 or in those under 80 but with low capacity to walk unaided; use of a dual mobility cup in patients with neuromuscular disorders or cognitive dysfunction, and for patients under 75 if at risk of falls and early dislocation. To calculate fall risk status we used the Morse Fall Scale (MSF) [10] upon patient admission. MFS > 45 was indicative of high risk. "
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    ABSTRACT: There is still debate over the limits of age and bone stock quality of patients on whom to use an un-cemented straight stem coated with hydroxyapatite (HA). We studied a group of 244 patients with a displaced intracapsular fracture of the femoral neck who underwent cementless hemiarthroplasty or total hip arthroplasty. 143 patients were reviewed at the two-year follow up. A fully HA-coated stem for intracapsular hip fracture results in a satisfactory return to pre-injury mobility and a low complications rate. The advantage reported in the literature of a low mortality rate with use of an un-cemented implant in elderly patients was shown to be greater still on finding an immediate primary stability and rapid osteointegration of the implant.
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    • "Schwendimann et al.[27]E. Schwendimann et al.[27]F. Haines et al.[10]G. "
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    ABSTRACT: BACKGROUND: inpatient falls are an important safety challenge, with around half causing physical injuries that compromise the recovery of older, frailer patients. Falls risk scores are in widespread use, but validation studies of their predictive values are few. OBJECTIVES: to assess the predictive values of the Morse falls score (MFS) in an acute general hospital. METHODS: age, admitting speciality, MFS, and any falls in the subsequent 7 days were collected in April 2011 through case note review and incident reporting systems. RESULTS: a total of 467 inpatients were included in the study; 51% were aged 75+ years; 56% had an MFS ≥25; 23% had an MFS ≥55; 28 fell. An MFS ≥25 was not significantly better than chance in the total sample or in any subgroups considered (YI: -0.01 to 0.15). An MFS ≥55 was significantly better than chance for the total sample (YI: 0.39), patients ≥75 years (YI: 0.31) and geriatrician-led wards (YI 0.37), although either sensitivity or specificity fell below 70% in each of these groups. Other subgroups did not demonstrate significantly better accuracy than chance, but may have been affected by type II error. CONCLUSIONS: using MFS ≥25 cannot be clinically justified, while using MFS ≥55 would be contingent on an effective intervention that was ethically acceptable to withhold from the patients with an MFS < 55, despite >40% of falls occurring in that group. Given similar limitations of alternative falls risk scores, hospitals should consider directly assessing and acting on individual patients' specific modifiable risk factors for falls.
    Preview · Article · May 2013 · Age and Ageing
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    • "Second, the review may be affected by contamination related to the implementation of other actions taken to prevent falls in the different environments studied, and by a possible Hawthorne effect. Moreover, limitations arise from the questionable quality of some of the studies selected: some offered no data on the age and/or sex distribution of the study population [15,43,46], or were deficient regarding the representativeness of the sample [22,25,44,46-48] or regarding the blinding of the researchers [22,27,43-45]. Another possible limitation concerns the search language: in the present review, the search languages used were limited to English, Spanish and Portuguese, and four studies were excluded for this reason [102-105]. "
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    ABSTRACT: Background Falls are a serious problem for hospitalized patients, reducing the duration and quality of life. It is estimated that over 84% of all adverse events in hospitalized patients are related to falls. Some fall risk assessment tools have been developed and tested in environments other than those for which they were developed with serious validity discrepancies. The aim of this review is to determine the accuracy of instruments for detecting fall risk and predicting falls in acute hospitalized patients. Methods Systematic review and meta-analysis. Main databases, related websites and grey literature were searched. Two blinded reviewers evaluated title and abstracts of the selected articles and, if they met inclusion criteria, methodological quality was assessed in a new blinded process. Meta-analyses of diagnostic ORs (DOR) and likelihood (LH) coefficients were performed with the random effects method. Forest plots were calculated for sensitivity and specificity, DOR and LH. Additionally, summary ROC (SROC) curves were calculated for every analysis. Results Fourteen studies were selected for the review. The meta-analysis was performed with the Morse (MFS), STRATIFY and Hendrich II Fall Risk Model scales. The STRATIFY tool provided greater diagnostic validity, with a DOR value of 7.64 (4.86 - 12.00). A meta-regression was performed to assess the effect of average patient age over 65 years and the performance or otherwise of risk reassessments during the patient’s stay. The reassessment showed a significant reduction in the DOR on the MFS (rDOR 0.75, 95% CI: 0.64 - 0.89, p = 0.017). Conclusions The STRATIFY scale was found to be the best tool for assessing the risk of falls by hospitalized acutely-ill adults. However, the behaviour of these instruments varies considerably depending on the population and the environment, and so their operation should be tested prior to implementation. Further studies are needed to investigate the effect of the reassessment of these instruments with respect to hospitalized adult patients, and to consider the real compliance by healthcare personnel with procedures related to patient safety, and in particular concerning the prevention of falls.
    Full-text · Article · Apr 2013 · BMC Health Services Research
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