A Systematic Review and Meta-Analysis of Fall Prevention Programs for Pediatric Inpatients

Abstract

Falls account for a high proportion of the safety accidents experienced by hospitalized children. This study aims to analyze the contents and effects of fall prevention programs for pediatric inpatients to develop more adaptable fall prevention programs. A literature search was performed using PubMed (including Medline), Science Direct, CINAHL, Embase, and Cochrane. We included articles published from the inception of each of the databases up to 31 March 2019. A total of 1725 results were reviewed according to the inclusion and exclusion criteria, and nine studies were selected. Data were analyzed using descriptive statistics and the Comprehensive Meta-Analysis program. Four of the nine studies divided their participants into a high-risk fall group and a low-or medium-risk fall group, and all studies used a high-risk sign/sticker as a common protocol guideline for its high-risk fall group. The odds ratio of 0.95 (95% Cl 0.550–1.640) for the fall prevention program in seven studies was not statistically significant. To develop a standardized fall prevention program in the future, randomized control trial studies that can objectively measure the fall rate reduction effect of the integrated fall prevention program need to be expanded.

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

“…A care bundle is a set of evidence‐based or self‐evident good practice‐based interventions for a defined patient population and care setting (Chen et al, 2020 ). Researchers also recommended developing an evidence‐based fall prevention programme (Guo et al, 2020 ; Kim, Kim, & Lim, 2021 ). In this study, first, through evidence retrieval, the latest evidence for preventing falls in hospitalized children was obtained.…”

“…The occurrence of falls in hospitalized children is the result of the accumulation of many factors (AlSowailmi et al, 2018 ; Parker et al, 2020 ; Kim & Lee, 2021 ). When formulating fall prevention measures, appropriate evaluation, environmental safety and health education for children, their families and nursing staff should be fully considered (Guo et al, 2020 ; Kim, Kim, & Lim, 2021 ). To this end, the care bundle protocol includes 4 dimensions and 20 items in this study.…”

“…Studies have shown that the risk factors for falls in hospitalized children are multifaceted (AlSowailmi et al, 2018; Parker et al, 2020; Kim & Lee, 2021) and comprehensive multifaceted intervention measures should be taken (Liu & Shang, 2021; Sheppard‐Law et al, 2022). At present, the nursing measures to prevent falls in hospitalized children mainly include fall risk assessment, using the high‐risk sign/sticker, close observation, assistance during children′s ambulation, family and staff education, composition of a safe environment and never leaving the child alone (Kim, Kim, & Lim, 2021).…”

Pediatric Oncology Rehabilitation: The Concerns With Falling

“…Most pediatric fall assessments are designed to be administered by inpatient nurses, and research has found a concerning lack of sensitivity in the available scales. 11 For example, the Humpty Dumpty Fall Scale is widely used but finds 80% of children to be at high risk for falls. Fall prevention programs for those determined to be at high risk by such scales typically consist of interventions that limit a patient's independent mobility, including putting up bed rails even for groups with low to moderate risk.…”

“…In pediatric patients with an oncology diagnosis, it is important to consider when a fall is developmentally age-appropriate rather than the result of a pathology or treatment. Most pediatric fall assessments are designed to be administered by inpatient nurses, and research has found a concerning lack of sensitivity in the available scales 11. For example, the Humpty Dumpty Fall Scale is widely used but finds 80% of children to be at high risk for falls.…”