Fall Reduction Intervention for Hospitalized Pediatric Patients at Risk for falls

Background: Falls represent a major public health problem around world. In hospital setting, falls continue to be number one adverse event with approximately 3-20% of inpatients falling at least once during their hospitalization. Fall measurements have been identified as important to patient outcomes by several organizations based on fact that falls most frequently reported adverse patient event in inpatient setting. Aim of this study to identify effect of risk reduction interventions for hospitalized pediatric patient, implement intervention, establish documentation guidelines, to provide a safe therapeutic environment. Subjects and Method; Design: This study was quasi-experimental study (Pre-/Post-test). Setting: study setting was pediatrics words of Menoufia University Hospitals at Shebin El Kom and Mansheat Sultan; and Shebin El Kom Teaching Hospital, Menoufia Governorate - Egypt. Sample: a). A convenience sample of a total number of 60 pediatric patients. They was selected according to following inclusion Criteria: all patients male and female with age 3-18 years already admitted to pediatrics words, at Menoufia University hospitals and their caregivers, Exclusion criteria were those falls of visitors or patient falls from other units not included in study, such as outpatient and neonatal intensive care units, B). A purposive sample of 40 nurses were selected who take-care of 60 pediatric patients. Tools for Data collection: 1. Humpty Dumpty Falls Scale to assesses pediatric inpatients’ risk for falls. 2. Interviewing Questionnaire for Nurses, 3. Interviewing Questionnaire for children' caregivers, and observational checklist for nurses practice. Results: By using Humpty Dumpty Falls Scale 31.7% were identified as low risk, and 68.3% were identified as high risk fall of hospitalized pediatric patients. present study revealed that 40% of high risk falls of pediatric patients their age from 3years to less than 8 years compared to 30 % of low risk fall at same age. As regards to gender, it was clarified that 38.3% pediatric patients of high risk fall score represent male patients compared to 15% of female. Considering Children Caregivers' knowledge regarding; serious symptoms that may occur after his / her fall represents 60 % at posttest. present study showed that most of studied pediatric nurses their knowledge was improved in posttest (satisfactory) than in pretest (wrong answer) in pretest regarding "Meaning of Fall". Most of nurse's practices were satisfactory after followed General Strategies for Falls Prevention for High Risk Pediatric Patients in post-test than in pretest. Conclusions: implementation of fall reduction intervention for hospitalized pediatric patients at risk for falls had significantly improve nurses knowledge and practice and improve children caregivers knowledge in-order to manage fall correctly and reduce fall occurrence. Recommendations: Implementation of risk assessment tool would allow all hospitalized children to be properly assessed for fall risk, and document of fall assessment tool into electronic medical record would allow nurse to implement fall reduction intervention for high risk children.