Reliability, Sensitivity, and Specificity of the Morse Fall Scale: A Hospitalized Population in Iran

Background and Objectives: One of the important indicators of patient safety and quality of hospital care is the patient’s fall. Patient falls are among the most crucial issues in the field of Never Events that will affect the health-care systems, and it is necessary to be considered to improve the safety of hospitalized patients. The present study was conducted to investigate the reliability, sensitivity, and specificity of the Morse Fall Scale (MFS) in Iran. Methods: In this prospective observational study, the reliability of the MFS was investigated through the inter-rater reliability. The researcher as the first evaluator and an experienced nurse as the second evaluator screened 180 patients in two educational hospitals in Tehran, Iran, between March and May 2021, using the access method with a MFS. The percentage of agreement of the evaluators was assessed using the Cohen’s kappa coefficient, and sensitivity and specificity were assessed using the receiver operating characteristic curve. Results: The results showed that the percentages of agreement between the two assessors in the patient fall history index, in the index of secondary diagnoses, in the index of assistive devices, in the index of IV therapy and heparin lock, in the index of gait/transferring, and in the index of mental status were 0.869, 0.916, 0.871, 1.00, 0.898, and 0.815, respectively. The MFS reliability was obtained by an interclass correlation coefficient of 0.825, sensitivity of 66.7, and specificity of 81.6. Conclusion: The reliability, sensitivity, and specificity of the Morse scale are relatively favorable. Therefore, it is suggested that a patient fall screening scale be designed to measure all dimensions related to the correct assessment of the patient in terms of clinical conditions and nonclinical factors related to patient fall.