Stubbs Kendra E, Sikes Lindsay
Phys Ther. 2017 Jan 1;97(1):97-104. doi: 10.2522/ptj.20150213.
Within a tertiary care pediatric medical center, the largest number of inpatient falls (8.84 falls per 1,000 patient days) occurred within a 14-bed rehabilitation/transitional care unit between February and September 2009. An interdisciplinary fall prevention program, called "Red Light, Green Light," was developed to better educate all staff and family members to ensure safety of transfers and ambulation of children with neurological impairments.
The purpose of this study was to develop and implement an interdisciplinary pediatric fall prevention program to reduce total falls and falls with family members present in this population.
Preintervention 2009 data and longitudinal data from 2010-2014 were obtained from retrospective review of event/incident reports. This quality improvement project was based on inpatient pediatric admissions to a rehabilitation care unit accommodating children with neurological impairments.
Data extraction included: total falls, falls with caregiver (alone versus staff versus family), type of falls, and falls by diagnosis. Descriptive statistics were obtained on outcome measures; chi-square statistics were calculated on preintervention and postintervention comparisons.
Total falls decreased steadily from 8.84 falls per 1,000 patient days in 2009 to 1.79 falls per 1,000 patient days in 2014 (χ12=3.901, P=.048). Falls with family members present decreased 50% postintervention. (χ12=6.26, P=.012).
Limitations included unit size nearly doubled postintervention, event reporting changed to both uncontrolled and controlled therapy falls (safely lowering patient to bed, chair, or floor), and enhanced reporting increased numbers of postintervention falls.
The Red Light, Green Light program has resulted in reductions in overall fall rates, falls with family members present, increased staff collaboration, heightened staff and family safety awareness, and a safer environment for patients at high risk for neurological or musculoskeletal impairments.
在一家三级护理儿科医疗中心，2009年2月至9月期间，在一个拥有14张床位的康复/过渡护理单元中，住院患者跌倒的数量最多（每1000个患者日有8.84次跌倒）。因此制定了一项名为“红灯，绿灯”的跨学科跌倒预防计划，以更好地教育所有工作人员和家庭成员，确保神经功能障碍儿童在转移和行走过程中的安全。
本研究的目的是制定并实施一项跨学科的儿科跌倒预防计划，以减少该人群中的总跌倒次数以及有家庭成员在场时的跌倒次数。
2009年干预前数据以及2010 - 2014年的纵向数据来自对事件/事故报告的回顾性审查。这个质量改进项目基于入住一家为神经功能障碍儿童提供服务的康复护理单元的儿科住院患者。
数据提取包括：总跌倒次数、有护理人员在场时的跌倒（单独与工作人员或家庭成员在一起时）、跌倒类型以及按诊断分类的跌倒情况。获取了关于结果指标的描述性统计数据；对干预前和干预后的比较进行了卡方统计。
总跌倒次数从2009年每1000个患者日8.84次稳步下降至2014年的每1000个患者日1.79次（χ² = 3.901，P = 0.048）。干预后有家庭成员在场时的跌倒次数减少了50%。（χ² = 6.26，P = 0.012）。
局限性包括干预后单元规模几乎翻倍、事件报告改为包括非受控和受控治疗跌倒（安全地将患者放到床上、椅子上或地板上），以及加强报告导致干预后跌倒次数增加。
“红灯，绿灯”计划降低了总体跌倒率、有家庭成员在场时的跌倒次数，增强了工作人员之间的协作，提高了工作人员和家庭成员的安全意识，并为神经或肌肉骨骼损伤高危患者营造了更安全的环境。
