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Development of a Scale to Identify the Fall-Prone Patient

Published online by Cambridge University Press:  29 November 2010

Janice M. Morse ,
Robert M. Morse  and
Suzanne J. Tylko
Janice M. Morse
Affiliation:
University of Alberta
Robert M. Morse
Affiliation:
University of Alberta
Suzanne J. Tylko
Affiliation:
University of Alberta
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Abstract

Patient falls are a serious problem, contributing to the morbidity and mortality of the elderly patient. This study reports on the development of the Morse Fall Scale. The scale consists of six scored items and discriminant analysis correctly classifies 80.5% of the patients. Validation of the scale by computer modeling was conducted. Data were randomly split and that analysis procedure repeated. Variables were obtained and weighted using half of these data, and these weights were tested on the remaining data. Similar results were obtained. Sensitivity of the scale was 78% and the positive predictive value, 10.3%. Conversely, specificity was 83% and the negative predictive value, 99.3%. Interrater reliability scores were r=.96. A prospective study in three clinical areas showed that the scale is sensitive to different patient conditions and to length of stay. Thus, the scale permits identification of the patient at risk of falling so that prevention strategies may be targeted to those individuals.

Résumé

Les chutes faites par les patients représentent un problème sérieux qui contribue à la morbidité et à la mortalité des patients âgés. L'étude actuelle rend compte de la mise au point du Morse Fall Scale. Cette échelle contient six items marqués et une analyse discriminate a répartit correctement 80,5% des patients. La justesse de cet outil a été prouvée au moyen d'un modèle calculé sur ordinateur. Les données ont été divisées au hasard et cette analyse a été répétée. Des variables ont été extraites et calculées en utilisant la moitié des données et ces valeurs ont ensuite été appliquées à l'autre moitié des données. Une forte ressemblance a alors été remarquée. La sensibilité de cette échelle s'est chiffrée à 78% et sa valeur prophétique positive à 10,3%. Le coefficient d'objectivité était de r = .96. Une enquête effeduée dans trois cliniques a démontré la sensibilité de l'échelle face aux différents états des patients et à la durée du séjour. Done il convient de conclure que l'échelle facilite l'identification des patients qui risquent de faire une chute, permettant ainsi aux responsables de formuler une stratégie de prévention conçue spécialement pour ces personnes.

Keywords

Patient fallsmeasurementpatient safety
Type
Articles
Information
Canadian Journal on Aging / La Revue canadienne du vieillissement , Volume 8 , Issue 4 , Winter/hiver 1989 , pp. 366 - 377
Copyright
Copyright © Canadian Association on Gerontology 1989

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