Home Healthc Now. 2024;42(5):295-300. doi: 10.1097/NHH.0000000000001282. Epub 2024 Sep 9.
Children with medical complexity (CMC) often require home healthcare services to manage chronic health conditions. Evaluation of home safety is recommended when children transition from hospital to home care, though despite best efforts, safety events, such as falls, still occur. Understanding the prevalence and causal factors of falls in CMC is critical for the development of fall prevention interventions and protocols. This study aims to describe demographics and reasons for falls reported in CMC receiving home healthcare services. A retrospective analysis was performed using data from an incident reporting database from January 2019 to March 2023. Participants included CMC who received home healthcare services from a single institution and had at least one documented fall. A total of 43 falls were experienced by 31 unique participants. The participants were predominantly male (58.1%), White (71.0%), and non-Hispanic/Latino (96.8%), with a median age of 10 years at the time of the fall. Primary diagnoses of CMC with falls included neurological disorders (41.9%), congenital chromosomal abnormalities (25.8%), and oncological conditions (16.1%). The most common reasons for falls were loss of balance (32.6%), unknown factors (19.6%), and trip/slips (17.4%). Half of falls were deemed to be potentially preventable. This study provides valuable insight into falls among CMC receiving home healthcare services and emphasizes the multifactorial nature of fall risks in this population. Understanding demographic characteristics, diagnoses, and causal factors of falls is critical in the development of proactive fall prevention strategies. Responding proactively to mitigate fall risks is an important step in enhancing the safety and quality of life for CMC. Future collaborative research efforts are warranted to validate findings and evaluate potentially successful fall prevention interventions.
患有复杂型医疗状况（CMC）的儿童通常需要家庭保健服务来管理慢性健康状况。当儿童从医院过渡到家庭护理时，建议评估家庭安全，尽管尽了最大努力，安全事件，如跌倒，仍会发生。了解 CMC 中跌倒的流行率和因果因素对于制定跌倒预防干预措施和方案至关重要。本研究旨在描述接受家庭保健服务的 CMC 报告的跌倒的人口统计学和原因。使用 2019 年 1 月至 2023 年 3 月的事件报告数据库，进行了回顾性分析。参与者包括从单一机构接受家庭保健服务且至少有一次记录在案的跌倒的 CMC。共有 31 名独特的参与者经历了 43 次跌倒。参与者主要为男性（58.1%）、白人（71.0%）和非西班牙裔/拉丁裔（96.8%），跌倒时的中位年龄为 10 岁。患有跌倒的 CMC 的主要诊断包括神经障碍（41.9%）、先天性染色体异常（25.8%）和肿瘤疾病（16.1%）。跌倒的最常见原因是失去平衡（32.6%）、未知因素（19.6%）和绊倒/滑倒（17.4%）。一半的跌倒被认为是可以预防的。本研究提供了有关接受家庭保健服务的 CMC 跌倒的有价值的见解，并强调了该人群中跌倒风险的多因素性质。了解跌倒的人口统计学特征、诊断和因果因素对于制定积极的跌倒预防策略至关重要。主动应对以降低跌倒风险是提高 CMC 安全性和生活质量的重要步骤。需要进行未来的合作研究，以验证研究结果并评估潜在有效的跌倒预防干预措施。
