Analysis of Fall Incidence Rate and Risk Factors at a Tertiary Care Hospital Setting for Inpatient Neurological Care using the Morse Fall Scale: A Prospective Study

Abstract

Introduction: Falls are the most common adverse events related to a patient safety in healthcare institutions. Falls during hospitalisation, particularly in inpatient rehabilitation facilities, are a common phenomenon among hospitalised individuals. The rationale of the present study is to reduce the incidence of falls by early identification of fall risk using an outcome measure. Aim: The aim of this study is to identify the fall incidence rate and associated factors responsible for falls in inpatients with neurological diseases using the Morse Fall Scale (MFS). Materials and Methods: This prospective study included 128 patients hospitalised in the Medicine and Neurosurgery Units of Justice KS Hegde Charitable Hospital in Mangaluru, Karnataka, Southern India. The study was conducted from March 2022 to March 2023. Factors were analysed through direct patient interviews, and fall risk scores were identified using the MFS during admission and discharge. Categorical variables were presented as frequency and percentage, while descriptive variables were presented as Mean±Standard Deviation. The pre-post comparison of the outcome measure was conducted using the Z-test. Results: The fall incidence rate in neurological inpatients was found to be 15 (11.7%), and the majority of the population belonged to moderate to high-risk of falls. During the hospitalisation period, 99 (77.3%) individuals had a fear of falling, while 29 (22.7%) did not have any fear of falling. Among the study population, 113 (88.3%) had no falls during their hospitalisation, while 15 (11.7%) experienced falls. The majority of subjects had a moderate risk of falls: 63 (49.2%) upon admission and 68 (53.1%) at discharge. There was a significant difference in the MFS scores between admission and discharge (p-value=0.024). Conclusion: The present study concludes that the MFS enables the identification of individuals at risk of falling. The variables related to these findings were the use of continuous medications, balance issues, fear of falling, followed by other factors such as age, length of hospital stay, previous hospitalisation, and sensory disorders.