Center for Nursing Research and Quality Outcomes, Maine Medical Center, Portland, ME 04102, USA.
J Nurs Manag. 2010 Jul;18(5):531-41. doi: 10.1111/j.1365-2834.2010.01095.x.
To evaluate currently available paediatric falls assessments instruments and to build a predictive fall model while also evaluating injury risk as a predictor of fall likelihood within the paediatric inpatient population.
There is lack of paediatric-specific fall assessment instruments and little information on the exploration of injury risk as related to falls in hospitalized children.
An ambispective, matched case-control design conducted in a sample of 100 inpatient paediatric patients. Results Two out of five instruments performed well to classify children at risk of falls. Longer length of stay, bleeding cautions/blood disorders and temperament/behaviour issues were significant predictors of fall likelihood. Cognitive impairment or neurological disease was not related to an increased likelihood of fall or injury risk for this sample.
More research is required to institute and standardize paediatric fall and injury risk assessments for everyday use. The explicit approach of using predictive modelling is critical in creating a universal, baseline reference for the most reliable and valid measure of assessment in children.
Findings of the present study increase awareness of nursing managers and leaders as to the necessity for fall and injury risk assessment as a safety and quality measure for inpatient paediatric populations.
评估现有的儿科跌倒评估工具,并建立一个预测跌倒模型,同时评估损伤风险作为住院儿科患者跌倒可能性的预测指标。
缺乏儿科专用的跌倒评估工具,关于损伤风险与住院儿童跌倒的关系的探索信息也很少。
采用前瞻性、匹配病例对照设计,对 100 名住院儿科患者进行研究。结果:五分之二的仪器能够很好地对有跌倒风险的儿童进行分类。住院时间延长、出血警告/血液疾病和气质/行为问题是跌倒可能性的显著预测指标。对于该样本,认知障碍或神经疾病与跌倒或损伤风险增加无关。
需要进一步研究以制定和标准化儿科跌倒和损伤风险评估,以便日常使用。使用预测模型的明确方法对于创建一个通用的、基线参考,以评估儿童最可靠和有效的评估措施至关重要。
本研究的结果使护理管理人员和领导者意识到,对住院儿科患者进行跌倒和损伤风险评估是安全和质量措施的必要性。