A Taxonomy of Human and Environmental Factors Related to Pediatric Patient Falls
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Publisher:The Ohio State University
Series/Report no.:The Ohio State University. College of Nursing Honors Theses; 2011
Parents expect their hospitalized children to be protected from harm; yet, among 26 children’s hospitals of varying sizes, from 6 to 172 children per hospital per year fall from their beds, cribs, chairs, couches, or stools, or slip, trip, and fall to the floor. A critique of four fall risk assessment tools revealed precision and accuracy levels well below epidemiological standards for instruments used to make patient care decisions. Hospitals need a paradigm shift from faulty predictions, to accepting responsibility for patient falls as medical errors. The purpose of this retrospective medical record review is to develop a taxonomy of the characteristics of pediatric patient falls and factors that contribute to falls. A random sample of 93 Adverse Event Reports (AER) from a total of 500 was selected for analysis. The sample includes children, ages one month to 18 years, for whom (AER) were filed for a fall between 2002-2008 (N≈500). AER content will be inductively analyzed by two independent raters, using the method of McLaughlin and Marascuilo (1990). Categories were identified that reflect human factors related to the child, parents, and caregiver and environmental factors related to the fall. The results show that more males (59.1%) fell than females. Over half of the children who fell had either a neurological (33.3%) or hematology/oncology (21.5%) diagnosis. The majority of children fell in their own room (74.2%) and fell onto the floor (82.8%). Many children had at least one adult present in the room (67.7%) and the majority of children fell on day (49.5%) and evening shift (40.9%) versus night shift (9.7%). The findings suggest that there are many human and environmental factors related to pediatric patient falls. This new taxonomy will represent beginning theory development on the phenomenon, and may provide direction for new fall prevention interventions.
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