This Morse Fall Risk Assessment Tool derived from the Morse Fall Scale (MFS) was converted using SafetyCulture and is used to help assess a patient’s likelihood of falling. Perform this Morse Fall Risk Assessment by answering 6 essential questions. This template includes a risk rating table which will help you assign a fall risk rating (High, Medium, Low) based on the responses to the 6 essential questions.
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Title Page
Patient's Full Name
Conducted on (Date and Time)
Attending Nurse's Full Name
Location
Item
Was there a history of falling? (immediate or within 3 months)
Was there a secondary diagnosis?
What ambulatory aid used?
Was there an intravenous apparatus or a heparin lock inserted?
How was the patient's gait or transferring mode?
What is the mental status of the patient?
Completion
Risk Rating Reference: • Look at the total score above and select the relevant risk level.
Overall Risk Rating
Attending Nurse's Full Name and Signature
SafetyCulture Staff
Morse Fall Risk Assessment
This Morse Fall Risk Assessment Tool derived from the Morse Fall Scale (MFS) was converted using SafetyCulture and is used to help assess a patient’s likelihood of falling. Perform this Morse Fall Risk Assessment by answering 6 essential questions. This template includes a risk rating table which will help you assign a fall risk rating (High, Medium, Low) based on the responses to the 6 essential questions.
The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions.
The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice.
You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction.
You should independently determine whether the template is suitable for your circumstances.
