Awareness and Applications of Attendant Parents Concerning The Risk of Fall in Pediatric Patient Population

Öz

Objective: This study was implemented for the purpose of determining the awareness and applications of attendant parents concerning the falls in pediatric population and precautions to be taken.

Methods: The descriptive and cross-sectional study was carried out with 350 attendant parents in pediatry clinics of a public hospital in Afyonkarahisar between 01.01.2019-01.04.2019. The data were gathered via data collection form consisting of three parts and Harizmi Fall Risk Scale.

Results: It was determined that majority of the attendant parents were women (92.8%) and mothers of the pediatric patients (82.6%). It was determined that only 61.4% of the attendant parents had been informed by clinical nurses on adaptation to clinic and patient room in case of hospitalization, whereas 42.3% had not been informed on the prevention of the risk of fall in the child attended. It was found that 58.9% of the pediatric patients who were attended had a higher risk of fall and their score average of the risk of fall was 22.43±5.07. It was determined that the attendant parents had higher awareness and applications concerning risk factors which could arise from the hospital environment and there were nonsufficient applications aimed at individual risk factors of fall concerning children and parent-related preventive behaviors.

Conclusion: It was concluded that parents attending pediatric patients did not have sufficient levels of awareness and applications concerning risk factors that could cause children to fall and there was a need for training.

Anahtar Kelimeler

• Falls,patient safety,pediatric nursing,harizmi fall risk scale

Pediatrik Hasta Popülasyonundaki Düşme Riskine Yönelik Refakatçi Ebeveynlerin Farkındalık ve Uygulamaları

Öz

Amaç: Bu çalışma refakatçi ebeveynlerin, pediatrik popülasyondaki düşmeler ve alınması gereken önlemler konusundaki farkındalık ve uygulamalarını belirlemek amacıyla yapıldı.

Yöntem: Tanımlayıcı ve kesitsel tipteki bu çalışma 01.01.2019-01.04.2019 tarihleri arasında Afyonkarahisar'daki bir kamu hastanesinin pediatri kliniklerinde refakatçi olarak bulunan 350 ebeveyn ile yürütülmüştür. Araştırma verileri, üç bölümden oluşan veri toplama formu ve Harizmi Düşme Riski Ölçeği ile elde edilmiştir.

Bulgular: Refakatçi ebeveynlerin çoğunluğunun kadın (%92,8) ve rekafat ettiği çocuğun annesi (%82,6) olduğu saptanmıştır. Refakat eden ebeveynlerin sadece %61,4'ünün hastaneye yattığında kliniğe ve hasta odasına uyuma yönelik klinik hemşireleri tarafından bilgilendirildiği,%42,3'ünün refakat ettiği çocukta düşme riskinin önlenmesine yönelik bilgilendirilmediği belirlenmiştir. Refakat edilen çocuk hastaların %58,9'unun yüksek düşme risk grubunda bulunduğu, düşme riski puan ortalamalarının 22,43±5,07 olduğu belirlenmiştir. Refakatçi ebeveynlerin, hastane ortamından kaynaklanabilecek risk faktörlerine ilişkin farkındalıklarının ve uygulamalarının daha yüksek olduğu, çocuk ile ilişkili bireysel düşme risk faktörlerine ve ebeveyn ile ilişkili önleyici davranışlara yönelik uygulamalarının yeterli olmadığı saptanmıştır.

Sonuç: Pediatrik yaş grubundaki hastalara refakat eden ebeveynlerin çocuklarda düşmeye neden olabilecek risk faktörlerine yönelik farkındalık ve uygulamalarının istendik düzeyde olmadığı ve eğitim gereksinimlerinin bulunduğu sonucuna ulaşılmıştır.

Anahtar Kelimeler

• Düşmeler,hasta güvenliği,pediatri hemşireliği,harizmi düşme risk ölçeği

Kaynakça

1. Singh I, Okeke J, Edwards C. Outcome of in-patient falls in hospitals with 100% single rooms and multi-bedded wards. Age Ageing. 2015;44(6):1032-1035. doi:10.1093/ageing/afv124.
2. McKechnie D, Fisher MJ, Pryor J. The characteristics of falls in an inpatient traumatic brain injury rehabilitation setting. J Clin Nurs. 2015;25(1-2):213-222. doi:10.1111/jocn.13087.
3. Chang CM, Lin HF, Chiang HH. A study on the relationship between age and inpatient falls in Taiwan. Int J NursPract. 2015;21(5):605-611. doi:10.1111/ijn.12342.
4. Lee E. Use of the nursing outcomes classification for falls and fall prevention by nurses in South Korea. Int J Nurs Knowl. 2018;30(1):28-33. doi:10.1111/2047-3095.12201.
5. Majkusová K, Jarošová D. Falls risk factors in an acute-care setting: A retrospective study. Cent. Eur. J. Nurs. Midwifery. 2014;5(2):47-53.
6. Costa-Dias MJ, Oliveira AS, Martins T, et al. Medication fall risk in old hospitalized patients: A retrospective study. Nurse Educ Today. 2014;34(2):171-176. doi:10.1016/j.nedt.2013.05.016.
7. Dunne TJ, Gaboury I, Ashe MC. Falls in hospital increase length of stay regardless of degree of harm. J Eval Clin Pract. 2014;20(4):396-400. doi:10.1111/jep.12144.
8. Joint Commission International. Preventing falls and fall-related injuries in health care facilities. Sentinel Event. 2015;55:1-5. [Çevrimiçi] https://www.jointcommission.org/assets/1/18/SEA_55.pdf. 15.05.2019’da erişildi.

9. Bouldin EL, Andresen EM, Dunton NE, et al. Falls among adult patients hospitalized in the United States: Prevalence and trends. J Patient Saf. 2013;9(1):13-17. doi:10.1097/PTS.0b013e3182699b64.
10. Baris VK, Intepeler SS, Yeginboy EY. The cost of serious patient fall-related injuries at hospitals in Turkey: A matched case-control study. Clin Nurs Res. 2018;27(2):162-79. doi:10.1177/1054773816671521.
11. Haines TP, Hill AM, Hill KD, et al. Cost effectiveness of patient education for the prevention of falls in hospital: Economic evaluation from a randomized controlled trial. BMC Med. 2013;11:1-12. doi:10.1186/1741-7015-11-135.
12. Kafantogia K, Katsafourou P, Tassiou A, Vassou N. Falls among hospitalized patients. Journal of Frailty, Sarcopenia and Falls. 2017;2:53-57.
13. Wong EL, Woo J, Cheung AW, Yeung PY. Determinants of participation in a fall assessment and prevention programme among elderly fallers in Hong Kong: Prospective cohort study. J Adv Nurs. 2011;67(4):763-773. doi:10.1111/j.1365-2648.2010.05535.x.
14. Moore M, Williams B, Ragsdale S, et al. Translating a multifactorial fall prevention intervention into practice: A controlled evaluation of a fall prevention clinic. J Am Geriatr Soc. 2010;58(2):357-363. doi:10.1111/j.1532-5415.2009.02683.x.
15. Anderson C, Dolansky M, Damato EG, Jones KR. Predictors of serious fall injury in hospitalized patients. Clin Nurs Res. 2015;24(3):269-283. doi:10.1177/1054773814530758.
16. Fields J, Alturkistani T, Kumar N, et al. Prevalence and cost of imaging in inpatient falls: The rising cost of falling. Clinicoecon Outcomes Res. 2015;3:281-286. doi:10.2147/CEOR.S80104.
17. Ugur E, Kara S, Yildirim S, Akbal A. Medical errors and patient safety in the operating room. J Pak Med Assoc. 2016;66:593-97.
18. Günes UY, Gürlek Ö, Sönmez M. A survey of the patient safety culture of hospital nurses in Turkey. Collegian. 2016;23:225-232. doi:10.1016/j.colegn.2015.02.005.
19. Güvenlik Raporlama Sistemi (GRSTR) 2017 Analiz İstatistikleri. [Çevrimiçi] https://www.saglikaktuel.com/d/file/28439,grs2017-sonpdf.pdf. 15.05.2019’da erişildi.
20. Towne SD, Ory MG, Smith ML. Cost of fall-related hospitalizations among older adults: Environmental comparisons from the 2011 Texas hospital inpatient discharge data. Popul Health Manag. 2014;17(6):351-356. doi:10.1089/pop.2014.0002.
21. Cox J, Thomas-Hawkins C, Pajarillo E, et al. Factors associated with falls in hospitalized adult patients. Appl Nurs Res. 2015;28(2):78-82. doi:10.1016/j.apnr.2014.12.003.
22. Chaudhary S, Figueroa J, Shaikh S, et al. Pediatric falls ages 0-4: Understanding demographics, mechanisms, and injury severities. Inj Epidemiol. 2018;5(Suppl. 1):7. doi:10.1186/s40621-018-0147-x.
23. Jamerson PA, Graf E, Messmer PR, et al. Inpatient falls in free standing children's hospitals. Pediatr Nurs. 2014;40:127-135.
24. Fujita Y, Fujita M, Fujiwara C. Pediatric falls: Effect of prevention measures and characteristics of pediatric wards. Jpn J Nurs Sci. 2013;10(2):223-231. doi:10.1111/jjns.12004.
25. Kingston F, Bryant T, Speer K. Pediatric falls benchmarking collaborative. J Nurs Adm. 2010;40(6):287-292. doi:10.1097/NNA.0b013e3181df10d9.
26. Hill-Rodriguez D, Messmer PR, Williams PD, et al. The Humpty Dumpty Falls Scale: A case-control study. J Spec Pediatr Nurs. 2009;14(1):22-32. doi:10.1111/j.1744-6155.2008.00166.x.
27. Oliver D. Assessing the risk of falls in hospitals: Time for a rethink? Can J Nurs Res. 2006;38:89-94. Kısacık Gürlek ve Fırın Pediatrik Hasta Popülasyonunda Düşme Riski 149 Kocaeli Üniversitesi Sağlık Bilimleri Dergisi, 2019;5(3):141-149
28. Cooper CI, Nolt JD. Development of an evidence based pediatric fall prevention program. J Nurs Care Qual. 2007;22:107-112. doi:10.1097/01.NCQ.0000263098.83439.8c.
29. Almis H, Bucak IH, Konca C, Turgut M. Risk factors related to caregivers in hospitalized children's falls. J Pediatr Nurs. 2017;32:3-7. doi:10.1016/j.pedn.2016.10.006.
30. Tzeng HM, Yin CY. Inpatient falls: The impact of family and personal care givers. Appl Nurs Res. 2009;22:159-165.
31. Cebeci F, Bektaş HA, Dağ GS, Karazeybek E. Families as hospital care givers: A pilot in Turkey. J Nurs Educ Pract. 2017;7(6):27-34.
32. Lee YL, Yip WK, Goh BW, Chiam EP, Ng HP. Fall prevention among children in the presence of care givers in a paediatric ward: A best practice implementation. Int J Evid Based Healthc. 2013;11:33-38. doi:10.1111/1744-1609.12003.
33. Razmus I, Davis D. The epidemiology of falls in hospitalized children. Pediatr Nurs. 2012;38(1):31-35.
34. Graf E. Magnet children’s hospitals: Leading knowledge development and quality standards for inpatient pediatric fall prevention programs. J Pediatr Nurs. 2011; 26(2):122–127.
35. Commodari E. Children staying in hospital: A research on psychological stress of caregivers. Ital J Pediatr. 2010;36(1):40-49. doi:10.1186/1824-7288-36-40.
36. Tehrani TH, Haghighi M, Bazmamoun H. Effects of stress on mothers of hospitalized children in a hospital in Iran. Iran J Child Neurol Autumn. 2012;6(4): 39-45.
37. Mahmoud FN, Elkreem MA. Hospitalized children and their mothers' needs and expectations from pediatric nurse. World Journal of Nursing Sciences. 2017;3(1):01-09. doi:10.5829/idosi.wjns.2017.01.09.
38. Al Sowailmi BA, Al Akeely MH, Al Jutaily HI, Alhasoon MA, Omair A, Al Khalaf HA. Prevalence of fall injuries and risk factors for fall among hospitalized children in a specialized childrens hospital in Saudi Arabia. Ann Saudi Med. 2018;38(3):225-229. doi:10.5144/0256.4947.2018.225.
39. Demir D, Yöntem SÇ, Sarı HY, Bektaş M. Çocuk hastalar için Düşme Riski Tanılama Ölçeği’nin geliştirilmesi. KUHEAD. 2013;10(3):34-41.
40. Yöntem S, Gök D, Sarı HY, Güntürkün FA. BUÇH II çocuk hastalarda düşme riski skoru: Harizmi ve BUÇH ölçekleri ile karşılaştırılması. İzmir Dr Behçet Uz Çocuk Hast Dergisi. 2017;7(2):105-112. doi:10.5222/buchd.2017.105.
41. Tanıl V, Çetinkaya Y, Sayer V, Avşar D, İskit Y. Düşme riskinin değerlendirilmesi. Sağlık Akademisyenleri Dergisi. 2014;1(1):21-26.
42. McWilliams JR. An evidence-based pediatric fall risk assessment tool for home health practice. Home Healthc Nurse. 2011;29(2):98-105. doi:10.1097/NHH.0b013e31820799a6.
43. Harvey K, Kramlich D, Champman J, Parker J, Blades E. Exploring and evaluating paediatric falls assessment instruments and injury risk indicators: An ambispective study in a tertiary care setting. J Nurs Manag. 2010;18(5):531-541. doi:10.1111/j.1365-2834.2010.01095.x.
44. Graf E. Examining inpatient pediatric falls: Understanding the reasons and finding the solutions. Joint Commission Perspectives on Patient Safety. 2005;5-6.
45. Shields L, Young J, McCann D. The needs of parents of hospitalized children in Australia. J Child Health Care. 2008;12(1):60-75. doi:10.1177/1367493507085619.
46. Mahmoud NF, Elkreem MA. Hospitalized children and their mothers' needs and expectations from pediatric nurse. World J Nursing Sci. 2017;3(1):01-09. doi:10.5829/idosi.wjns.2017.01.09.
47. Sander R. Problems identified in hospital care after a fall. Nurs Older People. 2011;23(4):11. doi:10.7748/nop.23.4.11.s8.
48. Sağlıkta Kalite Standartları Hastane Seti. (2016, 21 Mart) https://dosyamerkez.saglik.gov.tr/Eklenti/3460,skshastanesetiv5r1pdf.pdf?0 25.05.2019’de erişildi.
49. Schaffer PL, Daraiseh NM, Daum L, Mendez E, Lin L, Huth MM. Pediatric inpatient falls and injuries: A descriptive analysis of risk factors. J Spec Pediatr Nurs. 2012;17(1):10-8. doi:10.1111/j.1744-6155.2011.00315.x.