Analysis of the Pediatric Fall Risk Assessment Scale
Introduction
Today, promoting patient safety has become a crucial responsibility for the nurses working in the healthcare system. Since patient safety require wide-ranging interdisciplinary approaches, nurses carry out the task of ensuring that patients are not exposed to adverse effects while admitted. Healthcare centers tend to make good use of their ability to track and benchmark quality indicators such as fall rate, which is allowing health practitioners to come up with effective strategies to prevent the risk of fall within the healthcare system (Jamerson, et al., 2014). Evaluation of the patient fall is becoming an integral activity in the healthcare organizations, as nurses can use the evaluation programs to detect patients with high fall rates, thus, implementing prevention measures that will make sure that both adults and children are protected from high risks of falling.
Most of the hospitals have established the adult fall risk assessment scale programs. However, for units meant for children, the pediatric fall risk scales programs are not fully implemented (Hill‐Rodriguez, et al., 2009). This implies that for hospitals that have implemented the fall assessment scale, the tools are ineffective, as the tools are inappropriately utilized to hospitalize children who may become victims of fall risk. For this reason, patients fall remains a challenge for care hospitals (Jamerson, et al., 2014). Murray, Vess, and Edlund (2016) argue that despite the challenges, The Joint Commission and The Health and Medicine Division have emphasized that healthcare organizations should focus on decreasing any adverse effects during treatment and ensuring patient safety through the National Safety Goals.
Moreover, for positive outcomes in the case of dealing with the pediatric fall risk, The Joint Commission requires hospitals to have efficient methods that they can use to identify and screen children who are at the risk of pediatric fall (Murray, Vess, & Edlund, 2016). Thus, this project focuses on analyzing different research that have assessed the issue of pediatric fall risk. For a detailed analysis, the paper looks at the issue of fall risk, evidence outlined in the studies, ethical issues, dissemination methods that each study has focused on, and the studies’ outcomes or results.
Identification and Importance of the Issue
Although many studies have touched on the subject of pediatric fall risk, few have focused on reducing the risk of fall for pediatric adults and children. Therefore, for this project, the primary area of focus is to explore the practice that modern hospitals need to employ to can come up with appropriate measures that will enhance prevention pediatric fall risk for children and adult. Hill‐Rodriguez, et al. (2009) state that for hospitals to promote patient safety and care fall prevention programs for hospitalized patients, nurses have become innovative and use the most effective strategies to reduce the risks of patient fall. The researchers draw much focus on the prevention and reduction of fall event inside and outside hospitals.
On the other hand, Cooper (2014) focuses on analyzing the issue of patient fall, noting that in the U.S, nurses have identified safety measures that need to be applied in the hospitals as a way of helping in the reduction of the children’s and adult’s pediatric fall risk. Evidently, these studies create the much-needed awareness on the issue of pediatric fall risk and the effort in place to decrease and prevent the risk of falls for both adults and children. The studies are obliviously screening tools for the nurse caregivers because together with practitioners, they can utilize the findings to understand how to control, reduce, and prevent the risk of pediatric fall.
Appraising the Evidence
Different researchers have studied the subject of pediatric fall risk assessment scale, and for effective and useful research on the topic, researchers employ information from the review of the literature on the same subject. The four studies used for this analysis have reviewed books, journals, web pages, and case studies that have a direct relation to risk of fall. The fall-risk assessment is mostly connected to the information portrayed by the Joint Commission and The Health and Medicine Division associations.
Review of the Prevention Policy and Program
Murray, Vess, and Edlund (2016) reviewed the programs that are set by different associations to ensure that hospitals put measures developed to be taken as a priority so that hospitals can reduce the risk of fall and promote patient safety. Murray, Vess, and Edlund (2016) analyze how The Joint Commission and The Health and Medicine Division associations have emphasized on the implementation policies and programs that will promote the safety of the fall patients. In the review, according to The Joint Commission, hospitals have to use the most validated fall risk assessment tools, to prevent and decrease the risk of fall for the hospitalized patients. Murray, Vess, and Edlund (2016) note that the programs requiring the use of such tools are important because the tools offer direction to care decisions and ensure that the safety plans provide care for all fall patients within the healthcare system.
Review of the Fall Risk Assessment Tool
Cooper (2014) reviewed the use of the available evidence to show screening and fall prevention tools that hospitals need to employ to deal with the fall risk. Through the review of the previous studies, Cooper (2014) suggests that in the modern hospitals, there are a variety of risk assessment tools that need to be used as measures of preventing the risk of fall. The researcher lists the following as the major tools that hospitals need to use for the prevention of the fall risk:
- The long-term care facilities set to be used by the caregivers.
- Intensive assessments done by doctors or clinicians on either outpatient setting or long-term facilities.
- Assessments done by the physical therapists or doctors in the outpatient setting.
The Review of the Case Study Relating to the Risk of fall
Hill‐Rodriguez, et al. (2009) analyzed a case study on the incident of pediatric inpatient fall. In the review section, Hill-Rodriguez, et al. (2009) point out that the fall of hospitalized patient has increased. The researchers outline that the risk of fall ranges from 25% to 84% and the fall risk cases forms the second most-costly form of injury. The research has also focused on reviewing the use of instruments that are set to reduce and prevent pediatric fall. Evidently, the research indicates that many hospitals are using pediatric fall risk assessment scale adult tools to prevent the risk of fall for children, but this has not been successful (Hill-Rodriguez, et al., 2009). In the case study, it is apparent that many fall risk prevention instruments are set to prevent risk fall are for adults and not for children.
Review on the fall of Hospitalizes Children
In the review chapter, Jamerson, et al. (2014) analyzed the classification of pediatric fall and looked at the studies showing the fall rates. Jamerson, et al. (2014) reviewed the literature demonstrating the rate of children undergoing pediatric fall and the injury they have suffered in the process. Jamerson, et al. (2014) assert that the number of children who get injured due to the case of pediatric fall has increased to 36%, making the rate of children affected by the problem being near to that of the adults. From the literature of other researches, the study concludes by showing that the number of children going through the problem of fall increasing, hence, raising the need for healthcare intervention.
Synthesis of the Research Evidence
Gaps
While focusing on previous studies, the sources used in this paper outline that presently, few studies have focused on assessment of fall rates among children. Murray, Vess, and Edlund (2016) identify the role played by The Joint Commission and The Health and Medicine Division associations in developing and enforcing safety programs in healthcare centers. Additionally, Cooper (2014) discusses the role of physicians in ensuring that they are thorough in their diagnosis and monitoring of patients to ensure their safety. However, as Hill-Rodriguez, et al. (2009) outline, most assessment tools are only focused on adults and the same scales are frequently used to measure fall risks among children. Based on Jamerson, et al.’s (2014) analysis, such a move does not factor in the fact that there are as many children who are at high risks of falling as adults. The researchers note that there is a need for screening tools for fall rates among children. Further, there is also a need to focus on determining key elements that act as risk factors with regards to fall rates among children.
Future Studies
Consequently, future study will be necessary to investigate on the fall risk screening tools for children. Assessing the challenges that make it hard for hospitals to identify the appropriate tools for screening of the pediatric fall risk among children remains a core issue today. Therefore, developing assessment scales to measure fall rates among children depends on a critical analysis of risks that face children while admitted, which predisposes them to the dangers of falling.
The Strengths of the Articles to the Nursing Practice
The articles are important to the nursing practice as they provide guidelines for the nurses, especially the one assigned with the task of taking care of the fall patients. As many practitioners believe it is increasingly becoming necessary for the healthcare organization to improve the quality of care, the articles reviewed for this project play significant roles in quality improvement tasks.
First, from Murray, Vess, and Edlund’s (2016) research, it is evident that the article can help the nurses to position themselves better when providing improved care to the patients. In the study, the researchers suggest that children have a normal tendency to fall, but most of the healthcare organizations have not identified the best program that nurses can employ to ensure that the children who are at the risk of falling are given the care that they need.
Murray, Vess, and Edlund (2016) discuss the policies and programs set by The Joint Commission, as a way of hospitals improving their care for the fallen patient. In this case, the study is important to nurses, as it gives them the responsiveness they need concerning the screening method that they should adapt to facilitate treatment of the children falls risk prevention programs in an efficient manner.
The study by Jamerson, et al. (2014) has influencing strengths to the nursing practice. In the article, the researchers identify the strategies that the nurses should use to decrease the fall risk that involves all patients. The research shows healthcare practitioners that risk identification, communication, and adapting the prevention strategies are the best strategies that they can use to diminish the risk of fall for the hospitalized patients. This implies that nurses can integrate Jamerson, et al.’s (2014) study and these strategies to reduce the risk fall for children and adult.
On the other hand, Hill‐Rodriguez, et al. (2009) outline significant aspect that concerns pediatric fall tools. The study serves the purpose of giving the nurses an idea of adult fall tools. Throughout the study, nurses can learn more about the way fall risk tools work and the effective tools that can provide fall protection care services in a friendly manner.
Finally, the study by Cooper (2014), significance to the nursing organizations, as the article can assist the nurses to understand the fall evaluation tools, especially for the children. The study is a source of information to nurses, as the practitioners can utilize the research findings to ensure that pediatric fall risk evaluation tools are implemented in the Children’s Hospitals in a better way.
Project Processes and Outcome
Process
The studies used for this analysis are executed using primary data. For reliable and valid information, the studies review the case of a specific number of patient who has felt during hospitalization. Since the analysis focuses on improving the fall risk assessments scale, the review of the cases will involve both the children and adult. The cases reviewed are arranged according to the patient’s age, gender, diagnosis, and location.
Outcomes
The research outcomes are aimed to be positive and necessary to the improvement plans. The project intends to show the number of fall cases among children based on their age and gender. As a result, the project aims will show when the event of fall occurred, location, and factors that led to the increase of pediatric fall for the children.
As such, based on the studies used for this project, it is apparent falls for children and adults occur on every day and week, but mostly on the third day of hospitalization. The project will also consider the outcomes, relating to the locations issues, whereby the articles used for this project proposes that most of the fall cases occur in the patient rooms, bathroom, and outside the rooms.
Disseminating the Project Results to the Stakeholders
For this project, distributing the project’s outcomes will allow the researcher to distribute the objective of the study to all members who work in the hospitals involved in this study. The most effective methods that will be used for the dissemination of the project result are technology and face-to-face method where applicable. For technology method, the researcher will send the result to all members (doctors and nurses) through email. Upon understanding the result, the stakeholder will understand the way the result can influence his or her perspective concerning the risk of pediatric fall. The face-to-face method will most be used to distribute the result to the patients, in which the researcher will be required to take the patient through the results for clarification purposes.
Ethical Issues Related to the Improvement Project
In research, ethical issues promote the outcome of the study and assist the researcher in avoiding errors that might influence the research outcomes. Additionally, when the project adheres ethical issues, the researcher conducting the project will create a good relationship with the participant especially the patients, as this will show the case of professionalism. The ethical issues that the researcher will consider issues such as participants’ rights and safety. This will be substantial for the researcher because the participant will give the researcher supportive information and offer the researcher collaboration that is needed to complete the study. The researcher is also needed to follow the legal policies when conducting the project, as another way of observing the ethical issues that relate to research. Here, it is the responsibility of the researcher to ensure that no personal information concerning the patient is leaked or goes to the public.
Conclusion
In essence, it is evident that hospitals need to understand that hospitalized children are at a high risk of suffering the consequence of falling either in the hospital’s room, outside, and washrooms. As the studies present data from the case studies on the falling of the patients in the hospitals, the tools that are used to prevent the risk of patient fall are not effective. Thus, for this reason, the Joint Commission has set requirement for the hospitals, whereby the healthcare center needs to collect information concerning the fall risk and come up with ways that they will promote patients’ safety. The commission also requires hospitals to implement tools that will make sure enhance the case of hospitalized children have been assessed appropriately for fall risks, where the hospitals will get into a better position to benchmark pediatric fall.
References
Cooper, C. L. (2014). Evaluation of a pediatric fall risk assessment tool. College of Health and Human Services California State University, Fresno.
Hill‐Rodriguez, D., Messmer, P. R., Williams, P. D., Zeller, R. A., Williams, A. R., Wood, M., & Henry, M. (2009). The Humpty Dumpty Falls Scale: A Case–Control Study. Journal for specialists in pediatric nursing, 14(1), 22-32.
Jamerson, P. A., Graf, E., Messmer, P. R., Fields, H. W., Barton, S., Berger, A., … & Smith, A. B. (2014). Inpatient falls in freestanding children’s hospitals. Pediatric nursing, 40(3), 127-135
Murray, E., Vess, J., & Edlund, B. J. (2016). Implementing a Pediatric Fall Prevention Policy and Program. Pediatric Nursing, 42(5), 256-260.
