Medical Professional Publications

Fall Prevention

It is prevalent myth in many pediatric hospitals to think that falls are only a problem at adult hospitals. In fact pediatric falls have been divided into three categories:

  • Accidental falls - related to environment
  • Unanticipated physiological falls - related to low risk factors
  • Anticipated physiological falls - related to high risk factor

At Nationwide Children’s Hospital we experience falls in all three categories.  Each quarter an average of four children are seriously hurt as a result of a fall in either the inpatient or outpatient settings. In the second quarter of 2009, eight children suffered serious harm as a result of a fall that occurred while they were being cared for at Nationwide Children’s. Four patients, in the last 60 days, suffered serious injuries because of a fall that occurred at one of Nationwide Children’s offsite or inpatient facilities.

Even children who are not alone are at risk for falls. In 53 percent of the falls at Nationwide Children's, a parent or caregiver was present at the time. Most falls occur in the patient room (53 percent), followed by the bathroom (11 percent), and hallway (10 percent). Most falls occur in 2-to-3 year olds and 7-to-8 year olds. Fifty-five percent of all falls occurred while the patient was trying to get out of bed.

Children in certain age categories fall as a result of the normal developmental process. Despite that truth, it is the responsibility of every employee to eliminate any environmental risk that would put patients at a higher risk for falls. These include:

  • Keeping call lights within patient’s reach
  • Ensuring the patient’s bed is at its correct height
  • Ensuring rooms are free of clutter
  • Having assisted devices within patient’s reach
  • Keeping crib rails up

The Joint Commission requires that we assess our patient’s risk for falls. We perform this assessment on every patient at admission and reassess every 24 hours. We are now including our patients’ high risk for falls in unit census reports. We will be identifying patients high risk for falls by a yellow placard sign outside the door. If a patient is determined to be at high risk for falls, there are several ways to reduce risk for that patient.

  • Move patient closer to the nursing station
  • Perform rounding on our patients for toileting needs
  • Use two or three side rails to help with mobility of the patient
  • Provide non-skid socks to prevent falls
  • Provide a yellow armband to identify the high risk for falls.

We have developed a fall teaching point in EPIC that is part of the general orientation process. This will make it easy for fall prevention teaching to be documented. Please use the patient safety brochure and Helping Hands to aid in the teaching. Creating a safe environment every day is one of our core values and our first priority. Keeping our patients safe from falls will go a long way towards our goal of eliminating preventable harm at Nationwide Children's Hospital. If you have questions or would like more information, call Anamarie Rayburn, MSPH, CPHQ, Director of Quality Improvement Services at (614)722-4838.

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Nationwide Children's Hospital
700 Children's Drive Columbus, Ohio 43205 614.722.2000