Falling short: examination of the validity of methods used to identify paediatric hospital falls in NSW, Australia

Feuerlicht, Daniela; Agaliotis, Maria; Hinchcliff, Reece

doi:10.17061/phrp29121907

Cited by 3 publications

(7 citation statements)

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“…Higher incidence rates of newborn falls were reported across a seven‐hospital system in Oregon, America with an estimated incident rate of 1.4–1.6 newborn falls per 10,000 births (Helsley, McDonald, & Stewart, ; Monson, Henry, Lambert, Schmutz, & Christensen, ). Australian studies are sparse with one Sydney based study reporting a falls rate of 0.88 per 1,000 bed days in one Australian pediatric hospital (Feuerlicht, Sheppard‐Law, & Hinchcliff, ). Comparison between studies is difficult given the varied research methods, ways of reporting incident rates (bed days vs. patient days), definitions, and categorization of pediatric falls (Da Rin Della Mora, Bagnasco, & Sasso, ; Jamerson et al, ; Kingston et al, ).…”

Section: Introductionmentioning

confidence: 99%

Exploring Australian parents’ knowledge and awareness of pediatric inpatient falls: A qualitative study

Shala

Brogan

Cruickshank

et al. 2019

Specialist Pediatric Nursing

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Purpose While there has been extensive published research into adult inpatient falls, less is known about pediatric falls in Australia. Falls pose a safety risk to pediatric patients potentially causing harm, increased length of stay, and death. Parents play a central role in reducing falls‐related incidents given that, as parents, they provide care and/or oversee care delivered to their child at the bedside. Developing a better understanding of what parents and carers know about falls and associated risks, particularly those hospital‐naïve, is central to developing family centered strategies and targeted education to meet the needs of parents. Our study aimed to explore Australian parents’ knowledge and awareness of pediatric inpatient falls. Design Qualitative methods utilizing descriptive thematic analysis. Methods Parents of children and/or young people hospitalized during the last 6 months were eligible to participate. Potential participants attending the outpatient clinics of two tertiary pediatric outpatient clinics hospitals in Sydney, Australia were invited to participate in the study. Willing participants consented to complete a face to face in‐depth interview. Open‐ended questions sought to explore participants’ knowledge, knowledge acquisition, and awareness of inpatient falls. Interviews were digitally recorded and transcribed verbatim. Data familiarization and open coding were completed by researchers independently. Researchers explored and discussed emerging categories until patterns emerged and a consensus of dominant themes were agreed upon. ResultsInterviews were conducted with mothers (n = 17), fathers ( n = 4), or both parents together (n = 2) of a child or a young person who had been recently hospitalized. Four dominant themes emerged from the data namely: Supervision: falls won't happen, unexpected, parent priorities, and ways of learning about inpatient falls and risks. Despite parents' awareness of falls risk, parents were unaware that falls occur within a hospital setting and did not prioritize “falls prevention” during admission. Practice implications Findings have implications for nursing practice, particularly in the delivery, content, and timing of falls prevention education.

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Section: Introductionmentioning

confidence: 99%

Exploring Australian parents’ knowledge and awareness of pediatric inpatient falls: A qualitative study

Shala

Brogan

Cruickshank

et al. 2019

Specialist Pediatric Nursing

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“…Previous studies highlight the benefits of providing falls education to parents resulting in behavioral changes and a transient reduction in falls incident rates (Almis et al, 2017;Lee et al, 2013;Monson et al, 2008;Tung et al, 2009). Given that hospital-based fall incidents persist (Almis et al, 2017;Feuerlicht et al, 2020;Jamerson et al, 2014), targeted education informed by parents ' measured learning needs may be a more Yes (n = 145) 0.5 .043 0.3-0.9 0.5 .12 0.3-1.1…”

Section: Discussionmentioning

confidence: 99%

“…Hospital‐based pediatric falls are largely preventable, yet falls continue to occur resulting in significant hospital‐acquired harm or death (Almis et al, 2017; Feuerlicht et al, 2020; Jamerson et al, 2014; Wallace, 2014). The first epidemiological study to describe pediatric hospital‐based falls (Razmus et al, 2006) highlighted that there are clear differences in the incidence and the type of risk factors attributed to pediatric falls compared to adult populations.…”

Section: Introductionmentioning

confidence: 99%

“…The first epidemiological study to describe pediatric hospital‐based falls (Razmus et al, 2006) highlighted that there are clear differences in the incidence and the type of risk factors attributed to pediatric falls compared to adult populations. Overall, the reported incidence of pediatric falls is considerably lower (Feuerlicht et al, 2020, 2018; Jamerson et al, 2014) with rates of 0.77–1.36 per 1000 patient days (Feuerlicht et al, 2018; Fujita et al, 2013; Harvey et al, 2010) or a mean rate of 0.87 per 1000 patient days (Kingston et al, 2010). The lower pediatric incident rates contrast adult fall rates of 3.3–11.5 falls per 1000 patient days in the United States of America, 6.3 falls per 1000 bed days in the United Kingdom, and 3.7 harm related falls per 1000 separations in Australia (Australian Institute of Health and Welfare, 2021; Bouldin et al, 2013; Parsons et al, 2021).…”

Section: Introductionmentioning

confidence: 99%

“…The lower pediatric incident rates contrast adult fall rates of 3.3–11.5 falls per 1000 patient days in the United States of America, 6.3 falls per 1000 bed days in the United Kingdom, and 3.7 harm related falls per 1000 separations in Australia (Australian Institute of Health and Welfare, 2021; Bouldin et al, 2013; Parsons et al, 2021). Risk factors that are unique to pediatrics include a child's developmental age, male gender, a history of falls, and the presence of a parent and/or a carer at the bedside (Feuerlicht et al, 2020; Kingston et al, 2010; Schaffer et al, 2012; Wallace, 2014). Although there is no evidence of significance to report a causal relationship between parental presence at the time of a fall and the incidence of a fall, hospital‐based falls have occurred during parent supervision in 84% ( n = 133) of infants to 57% ( n = 104) of adolescents and 82.8% ( n = 82) of all aged children, respectively (Jamerson et al, 2014; Razmus et al, 2006) while newborns have been accidentally dropped from hospital beds or chairs while being held by a parent or breastfed (Helsey, 2010; Matteson et al, 2013; Monson et al, 2008).…”

Section: Introductionmentioning

confidence: 99%

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Predictors of parent's knowledge of hospital‐based pediatric falls

Sheppard‐Law

Brogan

Usherwood

et al. 2022

Specialist Pediatric Nursing

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Purpose: This study aimed to validate and to determine the individual characteristics and demographic factors associated with parents' knowledge of hospital-based pediatric falls and to identify parent populations more likely to report low levels of falls-related knowledge. Design: Validation of a questionnaire and a cross-sectional survey design. Methods: Parents (n = 200) of hospitalized children admitted to a tertiary specialist pediatric hospital in Australia completed an online questionnaire. Parents were asked to rate their hospital-based falls knowledge using a Likert scale (1-5). The questionnaire was administered to parents across six hospital wards, 1 day a week, from May to August 2019. Validation of the questionnaire involved factor analyses and reliability tests. Finally, descriptive analysis measured parents' knowledge, and a multivariate logistic regression analysis reported factors associated with parents' falls knowledge. All data were analyzed in Statistical Package for the Social Sciences (V27). Ethical approval was received for all stages.Results: The final version of the parent knowledge of falls (PKOF) questionnaire consisted of 23 questions across five domains (Cronbach α = .929-.70). Parents' knowledge of hospital-based falls ranged from 2.5 to 4.5, while knowledge that children may fall during parental presence rated the lowest score. Knowledge of inpatient falls was higher if their child had a high risk of falls (odds ratio [OR]: 2.1, p = .04) and they were Australian-born parents (OR: 1.9, p = .05).Practice Implications: The PKOF questionnaire is an evidence-based instrument developed for a pediatric hospital setting. Findings highlight knowledge gaps and parent groups with the highest risk of having inadequate hospital-based falls knowledge. The questionnaire enables pediatric nurses and educators to measure parents' knowledge of hospital-based falls accurately and consistently, and so to identify gaps and, subsequently, develop, implement, and evaluate falls education using an evidence-based approach.

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Development of an evidence‐based care bundle protocol for preventing falls in hospitalized children: Delphi study and trial test

Chen

Liu

2022

Nursing Open

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Aim The aim of the study was to develop an evidence‐based care bundle protocol for preventing falls in hospitalized children. Design Delphi method. Methods Based on the four basic concepts of nursing, the theoretical dimension and item pool of the care bundle first draft were constructed by searching evidence and referring to the care bundle for preventing inpatient fall issues by the China Nursing Quality Promotion Alliance. The Delphi method and trial tests were used to select and adjust items of the care bundle to form the care bundle protocol for preventing falls in hospitalized children. Results The first draft care bundle for preventing falls in hospitalized children included 4 dimensions and 21 items. In the 2‐round Delphi study, one item was removed, and three items were adjusted. One item was adjusted by trial test. Finally, the care bundle protocol for preventing falls in hospitalized children consisted of 4 dimensions and 20 items.

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Falling short: examination of the validity of methods used to identify paediatric hospital falls in NSW, Australia

Cited by 3 publications

References 7 publications

Exploring Australian parents’ knowledge and awareness of pediatric inpatient falls: A qualitative study

Exploring Australian parents’ knowledge and awareness of pediatric inpatient falls: A qualitative study

Predictors of parent's knowledge of hospital‐based pediatric falls

Development of an evidence‐based care bundle protocol for preventing falls in hospitalized children: Delphi study and trial test

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