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

Abstract

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.

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

“…low) (Shala et al, 2019). Parents of a child having a high risk of a fall were described as risk-aware and knowledgeable about falls and therefore mitigated the risk by managing the hospital environment accordingly (Shala et al, 2019).…”

“…low) (Shala et al, 2019). Parents of a child having a high risk of a fall were described as risk-aware and knowledgeable about falls and therefore mitigated the risk by managing the hospital environment accordingly (Shala et al, 2019). Lower falls incidence rates have been attributed to Japanese hospitals that share falls information with the families of highrisk patients (Fujita et al, 2013).…”

“…(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). Previous studies have attributed falls of this nature to parents' perception that hospital-based falls do not occur, lack of falls education, distractions at the bedside, parental exhaustion, or emotional parent and/or child distress (Bagnasco et al, 2010;Fujita et al, 2013;Jamerson et al, 2014;Matteson et al, 2013;Razmus et al, 2006;Shala et al, 2019).…”

“…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). Previous studies have attributed falls of this nature to parents’ perception that hospital‐based falls do not occur, lack of falls education, distractions at the bedside, parental exhaustion, or emotional parent and/or child distress (Bagnasco et al, 2010; Fujita et al, 2013; Jamerson et al, 2014; Matteson et al, 2013; Razmus et al, 2006; Shala et al, 2019).…”

“…However, the educational content to date has been limited to clinicians’ perceptions of parental learning needs. Given that parents’ lack of knowledge regarding falls has been previously shown (Shala et al, 2019) targeted education that is informed by parents’ knowledge and learning needs may be a prudent and proactive strategy. Empowering parents with falls prevention knowledge that is content relevant and dynamic is fundamental to improving patient safety and enables parents to share the responsibility as partners in care and to minimize and/or mitigate falls risk (Tobiano et al, 2013).…”