Comparing the Sensitivity and Specificity of Wilson-Sims Fall Risk Assessment Tool, Clinical Judgment and Morse Fall Scale in the Assessment of Fall Risk among Psychiatric Inpatients

Abstract

Effective fall risk assessment tool is important for preventive measures to be instituted among psychiatric inpatients. Our study aimed to compare the sensitivity and specificity of Wilson-Sims Fall Risk Assessment Tool (WSFRAT), clinical judgment and Morse Fall Scale (MFS) in the assessment of the risk of fall among psychiatric inpatients. All psychiatric inpatients who were admitted to psychiatric ward of Hospital Tuanku Fauziah, Malaysia from April 1st, 2019, till December 31st, 2020 were assessed for their risk of fall using WSFRAT, clinical judgment and MFS. The frequency and characteristics of actual fall event during period of hospitalization was documented. The study included a total of 400 psychiatric inpatients. Clinical judgment stratified 17 patients as high risk of fall (Mean age: 50.9 ± 12.13 years old, male predominance at 76.5 % and otherwise physically healthy), among which, five actually fell. Among these, four were considered as high risk by WSFRAT and two by MFS. The WSFRAT demonstrated higher sensitivity of fall detection as compared to MFS (60 % vs. 40 %), while the sensitivity of clinical judgment alone without specific fall risks tools was 80 % and a specificity of 96.7 %. Clinical judgement is derived from a comprehensive psychiatric assessment. The value of any objective assessment tool proved to be superior when an element of clinical judgement is concurrently added.