Exploring and evaluating five paediatric falls assessment instruments and injury risk indicators: an ambispective study in a tertiary care setting

J Nurs Manag. 2010 Jul;18(5):531-41. doi: 10.1111/j.1365-2834.2010.01095.x.


Aim: To evaluate currently available paediatric falls assessments instruments and to build a predictive fall model while also evaluating injury risk as a predictor of fall likelihood within the paediatric inpatient population.

Background: There is lack of paediatric-specific fall assessment instruments and little information on the exploration of injury risk as related to falls in hospitalized children.

Method: An ambispective, matched case-control design conducted in a sample of 100 inpatient paediatric patients. Results Two out of five instruments performed well to classify children at risk of falls. Longer length of stay, bleeding cautions/blood disorders and temperament/behaviour issues were significant predictors of fall likelihood. Cognitive impairment or neurological disease was not related to an increased likelihood of fall or injury risk for this sample.

Conclusions: More research is required to institute and standardize paediatric fall and injury risk assessments for everyday use. The explicit approach of using predictive modelling is critical in creating a universal, baseline reference for the most reliable and valid measure of assessment in children.

Implications for nursing management: Findings of the present study increase awareness of nursing managers and leaders as to the necessity for fall and injury risk assessment as a safety and quality measure for inpatient paediatric populations.

MeSH terms

  • Accidental Falls*
  • Adolescent
  • Case-Control Studies
  • Child
  • Child Welfare
  • Child, Preschool
  • Confidence Intervals
  • Female
  • Health Status Indicators
  • Humans
  • Infant
  • Infant, Newborn
  • Length of Stay
  • Logistic Models
  • Male
  • Nursing, Supervisory*
  • Odds Ratio
  • Pediatric Nursing
  • Reproducibility of Results
  • Retrospective Studies
  • Risk Assessment
  • Sensitivity and Specificity
  • Wounds and Injuries / nursing*