Evidence map›Paper›PMID 39220300›Full record

ArticlePediatric quality & safety

Reducing Falls in Hospitalized Children and Adolescents with Cancer and Blood Disorders: A Quality Improvement Journey.

Lisa K Morrissey, Phuc Ho, Maya Ilowite, David A Johnson, Colleen M Nixon, Marissa K Thomas, Julie A Waitt, Amy Wierzchowski, Ashley M Renaud

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Article in Pediatric quality & safety. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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2 · The registry

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4 · The record

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5 · Who and what money

Authors and funding

9 authors.

Lisa K MorrisseyFrom the Department of Nursing, Hematology/Oncology/Stem Transplant Program, Boston Children's Hospital, Boston, Mass.
Phuc HoFrom the Department of Nursing, Hematology/Oncology/Stem Transplant Program, Boston Children's Hospital, Boston, Mass.
Maya IlowiteDivision of Hematology/Oncology, Dana-Farber Boston Children's Cancer and Blood Disorders Program, Department of Pediatrics, Harvard Medical School, Boston, Mass.
David A JohnsonDepartment of Pediatrics, Boston Children's Hospital, Boston, Mass.
Colleen M NixonFrom the Department of Nursing, Hematology/Oncology/Stem Transplant Program, Boston Children's Hospital, Boston, Mass.
Marissa K ThomasFrom the Department of Nursing, Hematology/Oncology/Stem Transplant Program, Boston Children's Hospital, Boston, Mass.
Julie A WaittFrom the Department of Nursing, Hematology/Oncology/Stem Transplant Program, Boston Children's Hospital, Boston, Mass.
Amy WierzchowskiDepartment of Physical Therapy; Boston Children's Hospital, 300 Longwood Avenue, Boston, Mass.
Ashley M RenaudClinical Education, Informatics, Quality & Practice, Boston Children's Hospital, Boston, Mass.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Falls in hospitalized pediatric patients represent a serious patient safety concern. Children and adolescents with cancer and blood disorders have inherent risk factors that increase the likelihood of injury from falls. The Hematology/Oncology (HO) and Stem Cell Transplant (SCT) inpatient units at Boston Children's Hospital embarked on a multiyear quality improvement journey to reduce inpatient falls in this population. Methods: A targeted Falls Reduction Task Force implemented key initiatives between 2020 and 2023. These include enhancing communication strategies to heighten awareness of the highest fall-risk patients, conducting a formal apparent cause analysis on every fall with injury, and initiating a physical therapy-led program to reduce deconditioning. Outcome measures were total falls, rate of preventable falls with injury per 1000 patient days, and days between preventable falls with injury. Our quality improvement team used statistical process control charts to track changes over time. Results: The combined rate of preventable falls with injury per 1000 patient days decreased from 0.63 in fiscal year (FY) 2020 to 0.25 in 2023. The SCT and HO units achieved a maximum of 442 days and 410 days, respectively, between preventable falls with injury in 2021-2023, compared with 124 and 117 days in 2020. The two units observed a 51% reduction in total falls over 4 years. Conclusions: A multifaceted fall reduction quality initiative effectively reduced preventable falls with injury on pediatric HO and SCT inpatient units, thereby reducing avoidable harm in a vulnerable patient population.

Identifiers

PMID39220300
PMCPMC11365677

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