Authors (including presenting author) :
Wong MMC(1), Pang PF(1), Lam CW(2), Tsoh MY(3), Chan CF(4), Lau MS(4), Lee KL(2), Yan TY(3), Cheng YL(1), Wong KH(1), Ho KP(3), Cheuk RWM(3), Wong E(3), Tse WY (4), Kong S(4), Leung HW(4)
Affiliation :
(1) Department of Psychiatry, United Christian Hospital (2) Tai Po Hospital (3) Shatin Hospital (4) Castle Peak Hospital
Introduction :
Many hospitals used the Morse Fall Scale (MFS) throughout all hospital units to assess fall risk. It is a fall assessment tool intended for use in acute medical-surgical units, but has not been validated in psychiatric inpatient population. It was found that toileting was an important factor contributing to falling, which the MFS does not capture. Psychiatric inpatients have unique risk factors for fall such as their ambulatory nature, which are then compounded by other factors such as medications, anxiety and agitation. For these reasons, a fall risk assessment tool targeting at inpatient psychiatric patients is justified. The Wilson Sims Fall Risk Assessment Tool (WSFRAT) is designed for psychiatric population and it is a fall risk assessment tool recommended for psychiatric inpatients.
Objectives :
To compare the sensitivity, specificity, positive predictive value and negative predictive value of the WSFRAT and the Morse Fall Scale (MFS) so as to recommend a fall assessment scale which is more suitable for psychogeriatric inpatients.
Methodology :
Patients from the psychogeriatric wards of Shatin Hospital, Tai Po Hospital, Castle Peak Hospital and United Christian Hospital were recruited into our study. Both the WSFRAT and MFS were performed on these patients. Those who had fall incident within the study period were identified and their fall risk category assessed by the 2 scales was checked to see if the scale could predict the fall.
Result & Outcome :
A total of 183 psychogeriatric patients were recruited into the study from April 2019 to April 2020. Thirty patients were recruited from Shatin Hospital, another 30 from Tai Po Hospital, 80 from Castle Peak Hospital and 43 from United Christian Hospital. The proportion of males to females was almost similar. Most patients were assessed on day one or day two after admission. Among these 183 participants, four of them sustained a fall during their hospital stay, giving a prevalence of 2.19% (95% CI: 0.60%-5.5%). All four falls were regarded as having high risk of fall by WSFRAT but for MFS, only two of them were regarded as having high risk of fall. The sensitivity of WSFRAT was 100% which was much higher than that of MFS (50%.
Conclusion: WSFRAT is a good fall risk assessment tool in the tested population. Its items are specific to psychiatric population and it should be used to replace MFS in psychiatric settings.
