Development of an evidence-based care bundle protocol for preventing falls in hospitalized children: Delphi study and trial test.
Lixia Chen, Wenjing Liu, Hong Li
PMID 36319594WHAT IT FOUND
Nurses implemented a new paediatric fall-prevention bundle 92.3% of the time in a 45-child trial test, but hourly rounds and labels were hardest; it was revised, not tested for fewer falls.
Key findings
01A two-round Delphi consensus with 19 Chinese nursing experts produced a 20-item paediatric fall-prevention review draft.
02In a trial test of 45 hospitalized children, nurses' overall bundle compliance was 92.3%, but hourly rounds were done 54.8% and high-risk labels 64.5%.
03After the trial test, the protocol raised the Humpty Dumpty Falls Scale high-risk cut-off from 12 to 15 to reduce over-screening.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The evidence search was limited to English literature published within 5 years and to systematic reviews, practice guidelines and summaries of evidence. The authors state that the included evidence quality was not high and that there is some risk of bias. The Delphi experts and the trial test were all in China, so use outside China is unknown. The trial test used one 26-bed ward, 10 nurses and 45 children, and measured compliance rather than falls. Most Delphi experts were nursing managers or educators, not clinical nurses. The high-risk threshold was changed after the trial test, and the paper says future pilot studies will evaluate feasibility and effectiveness.
Declared interests
The authors received no financial support and declared no potential conflicts of interest.
The easy way to misread this
Do not read the 92.3% compliance as proof that the bundle prevents falls. The trial test measured nurses' adherence in 45 children, not fall rates, and the final protocol was revised after the trial.