oa Evaluation of an early screening tool for detection and prevention of fall in Emergency Department

Background: Anticipating falls in the Emergency Department is a very challenging task as it's often the most unpredictable setting. Fall risk assessment tools used in inpatient units do not adequately capture the risk factors present in patients presenting to the Emergency Department. The MORSE scale is implemented only at a latter phase of patient admission to the inpatient unit. The purpose of this study is to develop and implement a simple, fast and effective tool to identify the risk of fall at the triage.

Methods: We designed a tool to identify patients at risk of fall. We planned to randomly assign 200 patients equally in to the test and control arm. We created the Fall Risk Assessment Tool specifically for the use in the Emergency Department. The study was conducted at Hamad General Hospital, Emergency Department triage area. If a patient was identified as at risk for fall, a Fall risk sticker was pasted on top of the ED paper to indicate the risk. Any patient identified as at risk was re-evaluated throughout their stay in the Emergency Department.

Results: Hundred patients identified as at risk for fall at the initial triage were re-evaluated for fall risk using standard MORSE scale. Reassessment showed 67% of the cases identified at the initial triage come under high risk category using Morse scale, 31% had moderate risk and only 2% had low risk. There were no reported cases of fall. Hundred patients, excluded as low risk for fall at the initial triage were re-evaluated for risk for fall using the standard Morse Scale. Reassessment showed 98% of the excluded patient's came in the low risk category and 2% had moderate risk as per the MORSE scale.

Conclusion: Our tool was as safe as and effective in predicting falls as the MORSE Scale.