Morse Fall Risk Assessment Tool
Fall Risk is based upon Fall Risk Factors and it is more than a Total Score. Determine Fall Risk Factors
and Target Interventions to Reduce Risks. Complete on all patients at admission, at change of
condition; transfer to a new unit, and after a fall.
Please enter dates as follows: Feb. 12, 2012 (Mmm. DD, YYYY)
Part A:
Score
Morse Fall Risk
Assessment Tool
NO 0
YES 25
Secondary Diagnosis
NO 0
YES 25
Ambulatory
Aid
History of Falling
None/bedrest/nurse assist
0
Crutches/cane/walker
15
Furniture
30
Gait
Review Date:
Review Date:
Review Date:
NO 0
YES 25
IV or IV access
Mental
Status
Admission
Date:
Normal/bedrest/wheelchair
0
Weak
10
Impaired
20
Knows own limits
0
Overestimates or forgets limits
15
Total
Initial
To obtain the Morse Fall Score add the score from each category
Morse Fall Score
High Risk
45 and higher
Moderate Risk
25-44
Low Risk
0-24
Feb. 2012
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Fall Prevention and Management Intervention Careplan
YES 
NO 
Date: ___________ Initial ______
Fall Prevention/Intervention Careplan resolved YES 
NO 
Date: ___________ Initial ______
Fall Prevention/Intervention Careplan initiated
Part B:
Fall Prevention and Management Intervention Careplan
(Nurse to date and initial any changes made following reassessment)
Level 1 Interventions
Level 2 Interventions
Implement all of the following interventions
(check to implement the appropriate interventions below)
Identify Patient with a blue wristband
 Physio Therapy (PT) referral
 PT Recommendations
Identify Patient with a blue Fall Prevention
Sign
________________________________________________
Provide patient with non-skid socks
________________________________________________
________________________________________________
Patient will have at least one side rail down
(bottom left rail)
Move Patient closer to nurses desk
if at all possible
Patient/Family will be provided with education
on the FPMP. Have Patient/Family sign on
data base that they have received education
 Occupational Therapy (OT) Referral
 OT Recommendations
________________________________________________
________________________________________________
________________________________________________
 Mediation review
 Toileting routine
 Bed alarm
 Wheelchair with rear closing seat belt
 PRN Restraints
 Constant care/Family to stay with Patient
 Mat on floor
Feb. 2012
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