Patient Falls Prevention
Morse Fall Scale assessment, high-risk identification, and prevention protocols
Sushila Mehta (ICU-3) — HIGH fall risk (Morse 70). Confusion + IV lines. Do NOT leave unattended. Hourly nurse check MANDATORY.
Active Fall Risk Assessments
Sushila Mehta, 82F — ICU-3
Morse Score: 70 · Risk Factors: Age 82, confused (delirium), IV lines ×2, mobility impaired, diuretics
High Risk
Interventions in Place:
- ✓ Bed lowest position + side rails up
- ✓ Yellow fall-risk ID band applied
- ✓ Nurse call button within reach
- ✓ Non-slip socks
- ✓ Hourly rounding by nurse
- ✓ Family instructed not to leave alone
Rajan Kumar, 62M — GW3-2
Morse Score: 45 · Risk Factors: Post-op day 2, mild dizziness (opioids), ambulatory with walker
Moderate Risk
Interventions in Place:
- ✓ Bed lowest position
- ✓ Grab rails in bathroom
- ✓ Supervised ambulation only
- ✓ Teach-back: call for help before getting up
Priya Sharma, 34F — GW1-5
Morse Score: 20 · Risk Factors: Young, fully ambulatory, no gait issues
Low Risk
Interventions in Place:
- ✓ Standard precautions
- ✓ Orientation to call bell given