Morse Fall Scale Calculator
Assess patient fall risk using the validated Morse Fall Scale with evidence-based prevention interventions.
Morse Fall Scale Assessment
Morse Fall Scale Items
History of Falling
Immediate or within past 3 months
Secondary Diagnosis
≥2 medical diagnoses in chart
Ambulatory Aid
IV Therapy or Heparin Lock
Any IV access device
Gait
Mental Status
Additional Risk Factors
Morse Fall Scale Score
0
Low Risk
Protocol Level: Standard
Low Risk
0-24
Moderate
25-50
High Risk
> 50
Interpretation
Patient has low risk of falling. Standard fall prevention measures apply.
Universal Precautions
- • Maintain clean, dry, clutter-free environment
- • Ensure adequate lighting
- • Keep call light within reach
- • Encourage use of non-slip footwear
- • Orient patient to room and call light
Documentation Requirements
- • Document fall risk score and risk level
- • Document interventions implemented
- • Update care plan with fall prevention measures
- • Communicate risk level at handoff
- • Reassess with any change in condition
Reassessment Schedule
- • On admission
- • With any change in condition
- • After a fall
- • Transfer to different unit
- • Every shift (high risk patients)
- • At discharge planning
Disclaimer: The Morse Fall Scale is a validated screening tool but does not guarantee fall prevention. Clinical judgment should guide interventions. Document all assessments and interventions per facility policy. Fall prevention is a multidisciplinary team effort.