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Abstract
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As in other areas of health care, falls are a significant concern in the behavioral health (BH) setting. A study of fall incidence in adult BH facilities (Turner et al., 2020) found a fall rate of 8.55 falls per 1000 patient days and over 20% of those falls were associated with injuries. This is significantly higher than what has been reported in the general hospitalized pediatric population with a rate of 0.4-3.8 falls per 1000 patient days (Kim, Kim and Lim, 2021). There is a paucity of evidence specifically related to pediatric falls in the BH setting.
Given that a real risk of falls exists among the pediatric behavioral population, an instrument assessing fall risk is warranted. However, existing instruments may not be suited to this patient population. Nurses at inpatient pediatric (BH) units at a large health system in the western United States perceived the evidence-based pediatric fall screening tool they were using was not efficacious, as it was not accurately identifying patients at risk for falling in the pediatric BH setting. The clinical quality improvement manager for the BH units completed a literature review of the current fall risk instrument and discovered the instrument was not validated in pediatric BH patients. Subsequently, a Pediatric Fall Team comprised of BH experts, and an inpatient pediatric fall expert was developed and tasked with developing a tool that would identify patients who were at risk of falling in the pediatric BH setting.
Generally, the average pediatric BH patient has limited physical concerns and does not have co-morbidities that put them at risk for falling. The Pediatric Fall Team began by reviewing the past two years of reported falls and identified factors and similarities in the study population. They then searched the literature for pediatric fall risk instruments suitable for a pediatric BH environment. After analyzing the internal data and the literature, the team developed a fall risk instrument that better represented the unique needs of pediatric BH patients. Utilizing current standard pediatric fall risk instruments and clinical knowledge from the field, the team assembled a comprehensive list of 24 items that captured fall risk for the pediatric BH patient in both inpatient and ambulatory environments. To both evaluate and further develop the instrument, the research team was invited to join the workgroup...
Language: en |