Analysis of Falls within Paediatric Hospital and Community Healthcare Settings

Abstract

PurposeTo identify characteristics of paediatric falls within a healthcare setting. Design and methodsA retrospective analysis of falls occurring within inpatient, outpatient, emergency and community healthcare settings of children aged 0–<18 years was conducted using data from the Children's Health Queensland Hospital and Health Service (CHQ-HHS) Clinical Incident Database and Electronic Medical Record between January 1st 2015 and December 31st 2017. One-sample and two-sample Chi-squared tests with post-hoc tests were performed to assess relationships between categorical variables. ResultsThe final dataset contained 385 fall events. Children 0–2 years fell most frequently (46.75%) and falls were higher in males (55.58%). Falls from bed were the most common mechanism (30.65%). The incidence rate of inpatient falls was 0.53 falls per 1000 bed days in the tertiary hospital setting and 1.2% of presentations to inpatient community health facilities. Falls from bed were most common in the tertiary hospital inpatient setting (39.84%, p < .001) and the emergency department (72.13%, p < .001). Falls from furniture/equipment constituted 26.04% of outpatient falls. Most falls occurred in the presence of parents/caregivers (79.48%) and 4.66% of fallers sustained multiple falls. ConclusionsThis study provides a comprehensive review of the characteristics of fall events in CHQ-HHS over a three-year period and summarises the existing literature in paediatric fall prevention. Practice implicationsRisk assessment and management plans should focus on education, particularly surrounding bed safety. Our findings have informed the development of an integrated evidence-based paediatric-specific fall risk assessment tool and management plan to prevent falls in hospital and community healthcare settings.