Paper
Wednesday, 19 July 2006
This presentation is part of : Evidence-Based Practice Models
Creating a Pediatric Fall Assessment Tool
Roni L. Cummings, RN, MSN, Quality Resource Management, Phoenix Children's Hospital, Phoenix, AZ, USA
Learning Objective #1: Identify at least four contributing factors, which place a pediatric patient at risk for falls.
Learning Objective #2: Identify the need and differences for assessing a child at risk for falls vs. adult at risk for falls.
Background:  A new patient safety goal was created for 2005 to reduce the risk of patient harm resulting from falls. Acute care settings providing pediatric care were challenged to implement a tool to determine a patient’s risk for falls. Assessment tools have been created for use in the adult population to evaluate the potential for falls.  However, existing tools are not appropriate for use with pediatric patients.  Methods: The search for evidence began in CINAHL 2000 – 2004, 2163 articles were found.  No studies were found in the Cochrane systematic reviews that related to pediatric falls in acute care settings.  An investigation was undertaken to determine how many children hospitalized at Phoenix Children’s Hospital fell in 2004, and to identify potential risk factors that would assist nurses in predicting those at risk of harm from falls.  Results: Medical record review for 78 children who fell revealed 28 factors as potential predictors for falls.  For this review, the majority of pediatric falls resulted from developmental and environmental factors.  Key factors that predicted which children were at risk for falls include; children learning to walk contribute to 26 % falls, males were more likely to fall at the rate of 56%,  26% fall between the hours of 6 PM to 8 PM, 42% fell while ambulating, and 64% fall in the presence of their parents.  Conclusions: In developing a fall reduction program to reduce the risk of harm from falls, environmental factors should be carefully evaluated and included in a risk assessment profile.

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