Fear of falling : Association between the Modified Falls Efficacy Scale, in-hospital falls and hospital length of stay

Rationale, aims and objectives: Falls in hospital are costly and may impact psychologically on fallers causing them to avoid mobilization, thereby affecting recovery rate and hospital length of stay. The study aim was to investigate the relationships between fear of falling, falls risk, in-hospital falls and hospital length of stay. Method: A convenience sample (n=141) of patients from a large tertiary hospital was recruited. Data were collected over 6 months using the Modified Falls Efficacy Scale (MFES) on ward admission, prior to discharge, and in the event of a fall. Results: A third of the sample (n=44) was admitted to hospital following a fall. The majority (65%) was categorized as medium falls risk. Twenty-five participants sustained a total of 30 falls during their hospital admission of which 13 sustained a total of 15 falls on the study wards. The mean admission MFES score was 5.5, which increased to 6.1 on hospital discharge. Fallers scored significantly lower admission MFES scores than non-fallers (P=0.003). Receiver-operating curve analysis indicated that admission MFES score was a ‘fair’ predictor of sustaining a fall (area under curve=0.71, P=0.013). With a cut-off score of 5, admission MFES sensitivity was 77% and specificity was 55%. Study ward fallers had significantly longer hospital length of stay (49 days) than non-fallers (27 days; P=0.037). Furthermore, regardless of whether the participant was a faller or not, significantly longer hospital stay was associated with an admission MFES score of less than 5. Conclusions: An admission MFES score of less than 5 is an effective predictor of patient falls and is associated with a significantly longer hospital length of stay.