Assessment Tool: Morse Fall Scale (MFS)

Rate each of the six items based on the patient's current status. Implement the appropriate fall-prevention protocol based on total score. Reassess with any change in condition.

Morse Fall Scale (MFS)

A six-item rapid fall-risk screening tool validated for acute-care inpatients. Total score 0–125. Developed by Janice Morse (1989).

Risk thresholds

0–24

Low risk

25–44

Moderate risk

≥ 45

High risk

History of falling

Any fall in the past 3 months (including this admission)

Secondary diagnosis

More than one medical diagnosis documented

Ambulatory aid
IV access / heparin lock
Gait
Mental status