Pediatric falls: Effect of prevention measures and characteristics of pediatric wards

Abstract

This study aimed to identify the effect of fall prevention measures and characteristics of wards on the rate of pediatric falls. Data on study variables were collected using a cross-sectional design and questionnaires of 603 randomized general hospitals in Japan. Among the hospitals that were contacted, 252 (41.8%) returned their questionnaires. The questionnaires included the annual number of falls, whether fall prevention measures were implemented, and characteristics of the wards. Data were analyzed from questionnaires from 162 of the hospitals, which included those that answered the number of falls. The pediatric fall rate was 1.36/1000 patient-days. Facilities were more likely to have a lower fall rate if they had a longer "length of stay" (P < 0.001), "shared information in high-risk patients and monitored them carefully" (P < 0.001), had higher totals for the "number of study sessions for novice nurses" (P = 0.01),and "used a pamphlet to educate patients and caregivers regarding appropriate use of side rails" (P < 0.001). Facilities that had a "playroom" (P < 0.001), higher "novice nurse-to-nurse ratio" (P < 0.001), and those at which "caregivers were necessary for hospitalization" (P = 0.04) were more likely to have a higher fall rate. The results of the present study suggest that education of parents and novice nurses on fall prevention is the most effective method of reducing pediatric falls. It is important to implement intensive fall prevention for high-risk patients and develop valid pediatric fall risk assessment tools.