Arkansas Children's Hospital, Little Rock, AR, United States of America.
J Pediatr Nurs. 2019 May-Jun;46:100-108. doi: 10.1016/j.pedn.2019.03.008. Epub 2019 Mar 21.
To reduce harm related to pediatric falls, a quality improvement project was conducted at a children's hospital.
An interprofessional team designed and implemented evidence-based interventions to align with the hospital's journey to reduce patient harm. These interventions included selection and implementation of a fall risk assessment tool, implementation of fall bundle elements, and implementation of fall prevention education to patients and families. Surveys, audits, and rate of falls were used to evaluate the project.
Fall bundle compliance increased from 27% to 88% and there were zero patient falls in five out of the six months after implementation a comprehensive pediatric fall prevention program.
Implementing pediatric-specific, evidence-based interventions can help to reduce patient falls. There was a substantial increase in fall bundle compliance and a decrease in falls and falls with injury.
Engagement and empowerment of clinical nurses in the quality improvement process design and implementation can substantially improve patient outcomes and patient safety while reducing harm. Future research is needed to determine factors that promote enhanced reporting needed to determine the true incidence of patient falls in pediatric inpatient and outpatient settings.
为了减少与儿科跌倒相关的伤害，在一家儿童医院开展了一项质量改进项目。
一个多专业团队设计并实施了基于证据的干预措施，以符合医院降低患者伤害的旅程。这些干预措施包括选择和实施跌倒风险评估工具、实施跌倒捆绑包要素以及对患者和家属进行跌倒预防教育。使用调查、审计和跌倒率来评估项目。
跌倒捆绑包的依从性从 27%增加到 88%，在实施全面儿科跌倒预防计划后的六个月内，有五个月没有发生患者跌倒，且没有跌倒导致受伤的情况。
实施儿科特定的、基于证据的干预措施可以帮助减少患者跌倒。跌倒捆绑包的依从性大幅提高，跌倒和跌倒致伤的情况减少。
在质量改进过程的设计和实施中，让临床护士参与并赋予其权力，可以显著改善患者结局和患者安全，同时减少伤害。需要进一步研究以确定促进增强报告的因素，以确定儿科住院和门诊环境中患者跌倒的真实发生率。
