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Reduction of pediatric falls: a quality improvement project at an urban children's hospital
Dissertation

Reduction of pediatric falls: a quality improvement project at an urban children's hospital

Lynn Burbank
Doctor of Nursing Practice (D.N.P.), Drexel University
2016
DOI:
https://doi.org/10.17918/etd-7226
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Burbank_Lynn_2016272.50 kB
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Abstract

Risk assessment Children--Health risk assessment Nursing
Hospitalized pediatric patients are at risk for falls due to a variety causes. Risk for falls is measured through a variety of assessment tools. A gap in the literature regarding the accuracy of the assessment tools to predict pediatric patients at risk for falls, factors which contribute to falls, appropriate education for nurses and families, and evidence-based interventions to minimize risk. Of significance is in the published literature is lack of consistent definition of a fall, contributing factors associated with fall risk, and lack of sensitivity and specificity of existing falls risk assessment tools. A retrospective chart review of patients who did not sustain a fall during admission to an urban pediatric hospital (N=154) was conducted to compare accuracy of fall risk assessment scores with patients who did fall (N=33) during hospital admission. The chart review of the electronic medical records reflected patients admitted during the time period of April 01, 2015- December 31, 2015. The Graf PIF falls risk assessment tool (GPFS) used to assess risk at the study hospital was compared with the Humpty Dumpty Falls Scale and the Morse Falls Scale. In this study the GPFS was found to be effective in identifying patients who did not fall and patients who did fall. Of the patients who fell the GPFS tool gave 100% of the patients a score of 2 or more; of the patients who did not fall 89% received a score of 1 or less. The chi-square test for significance demonstrated that the 2-sided difference is less than .05 therefore the null hypothesis could be rejected and the difference in proportions of children predicted to fall and not fall are significant. The GPFS is an appropriate tool to assess pediatric risk for falls. Further research should be conducted to develop education for nurses and families to reduce risk for falls in pediatric hospitals.

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