Falls are the leading cause of nonfatal injuries treated in emergency departments in the United States. Children’s falls have the potential for injury and other negative patient outcomes (e.g., increased length of hospital stay and increased costs). To prevent these fall occurrences and injury outcomes, a comprehensive assessment of the factors surrounding falls in hospitalized children is essential to developing best-practice interventions.
The overall purpose of the multisite study was to identify the patient characteristics and environmental factors related to falls for patients aged 18 years and younger.
This descriptive study was part of a multisite study based on inpatient pediatric falls reported over a six-month period.
No significant differences were found for age, weight, gender, or race between injured and non-injured children. Eighteen fall events (58.1 percent) resulting in an injured child occurred in the hospital room, and no child was dropped. In five events where injury occurred, the child fell from the hospital bed. The floor surface was linoleum in 12 of the injured cases (54.6 percent). Of the 53 falls, 37 were witnessed (69.8 percent). Of the 53 falls that were reported, 31 falls resulted in an injury. Twenty-four of the 31 falls (77.4 percent) resulted in a minor injury, and seven of the 31 falls (22.6 percent) were categorized as moderate. There were no injuries classified as “major.” This study and others found the majority of falls occurred within the inpatient room.
This study utilized a convenience sample from one site and only included inpatients, limiting the generalizability of the findings. Patients older than 18 years and patients admitted to residential psychiatric units were excluded from the study. The small sample size limits the generalizability of the outcomes due to the low power of the inferential analysis. Information about the number of patients who were assessed by the risk-assessment tool, but did not fall, was not collected in this study; hence, specificity, positive predictive value, and odds ratios could not be calculated. More than one-third of the patients did not have their fall history identified and were thus marked as “unknown.”