Morse Fall Risk Assessment Tool

Fall Risk is based upon Fall Risk Factors and it is more than a Total Score. Determine Fall Risk Factors
and Target Interventions to Reduce Risks. Complete on all patients at admission, at change of
condition; transfer to a new unit, and after a fall.
Please enter dates as follows: Feb. 12, 2012 (Mmm. DD, YYYY)

Part A:
Admission
Morse Fall Risk Review Date: Review Date: Review Date:

Score
Date:
Assessment Tool
NO 0
History of Falling
YES 25

NO 0
Secondary Diagnosis
YES 25

None/bedrest/nurse assist 0
Ambulatory
Aid

Crutches/cane/walker 15

Furniture 30

NO 0
IV or IV access
YES 25

Normal/bedrest/wheelchair 0
Gait

Weak 10

Impaired 20
Mental
Status

Knows own limits 0

Overestimates or forgets limits 15

Total

Initial
To obtain the Morse Fall Score add the score from each category

Morse Fall Score

High Risk 45 and higher
Moderate Risk 25-44
Low Risk 0-24

Feb. 2012 1of 2

 Fall Prevention and Management Intervention Careplan

Fall Prevention/Intervention Careplan initiated YES  NO  Date: ___________ Initial ______

Fall Prevention/Intervention Careplan resolved YES  NO  Date: ___________ Initial ______

Part B:
Fall Prevention and Management Intervention Careplan
(Nurse to date and initial any changes made following reassessment)
Level 1 Interventions Level 2 Interventions
Implement all of the following interventions (check to implement the appropriate interventions below)

 Physio Therapy (PT) referral

Identify Patient with a blue wristband
 PT Recommendations
Identify Patient with a blue Fall Prevention
Sign ________________________________________________

Provide patient with non-skid socks ________________________________________________

________________________________________________
Patient will have at least one side rail down
(bottom left rail)  Occupational Therapy (OT) Referral

Move Patient closer to nurses desk  OT Recommendations

if at all possible
________________________________________________

Patient/Family will be provided with education ________________________________________________

on the FPMP. Have Patient/Family sign on
data base that they have received education ________________________________________________

 Mediation review

 Toileting routine

 Bed alarm

 Wheelchair with rear closing seat belt

 PRN Restraints

 Constant care/Family to stay with Patient

 Mat on floor

Feb. 2012 2of 2