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Abstract
Scopo: identificare i fattori di rischio caduta più significativi nel contesto locale e migliorare la qualití dell'assistenza erogata ai pazienti pediatrici fornendo indicazioni per interventi di prevenzione delle cadute. Materiale e Metodi: per esaminare la correlazione tra le cadute e i fattori di rischio di caduta è stato condotto uno studio osservazionale retrospettivo caso controllo, il campione è costituito da tutti i bambini caduti dal 2004 al 2011 di etí anagrafica compresa tra 0 – 18 anni, per i quali era presente la scheda di segnalazione dell'avvenuta caduta. Risultati: Nello studio sono stati inclusi 108 bambini (36 casi e 72 controlli). I dati hanno mostrato che l'assunzione di 4 farmaci è correlata al rischio di caduta ma la presenza di terapia endovenosa pare essere un fattore che protegge dal rischio di caduta. Conclusioni: Lo studio conferma l'importanza epidemiologica del problema delle cadute in etí pediatrica. Una valutazione prospettica su un campione di maggior dimensioni potrebbe aiutare a identificare ulteriori variabili indipendenti. Questo studio può rappresentare un punto di partenza per ulteriori analisi. Parole chiave: pazienti ospedalizzati, fattori di rischio, bambini, cadute, nursing
ABSTRACT
Purpose: To identify the main and most significant risk factors for falls and improve the quality of care delivered to pediatric patients by providing indications for interventions for the prevention of falls. Methods: To investigate the correlation between falls and risk factors a retrospective observational case-control study was carried out, the sample was made up by all children who fell from 2004 to 2011 between 0-18 y.o. for which there was a record of the fall. Results: 108 children were included in the study (36 cases and 72 controls). The data showed that 4 drugs have a correlation with falls,on the contrary intravenous therapy seemed to be a factor that protects against the risk of falling. Conclusions: The study confirms the importance of the problem of falls in children. A greater sample size could help to identify additional independent variables. This study may represent a starting point for further analysis. Keywords: Hospital patients, risk factors, children, falls, nursing
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Riferimenti
- Bagnasco, A., Sobrero, M., Sperlinga, L., Tibaldi, L., Sasso, L., (2010). Accidental falls in hospitalized children: an analysis of the vulnerabilities linked to the presence of caregivers. J Prev Med Hyg, 51:92-96.
- Child Health Corporation of America Nursing Falls Study Task Force, (2009). Pediatric Falls: State of the science. Pediatr Nurs, 35(4):227-231.
- Cooper, C L., & Nolt, JD. (2007). Development of an evidence-based pediatric fall prevention program. Jour Nurs Care Qual, 22(2):107-112.
- Gill, AC., Kelly, NR. Prevention of falls in children. UpToDate. www.uptodate.com data ultimo accesso 01/06/2012
- Graf, E., (2011). Magnet Children's Hospitals: Leading Knowledge Development and Quality Standards for Inpatient Pediatric Fall Prevention Programs. J Pediatr Nurs, 26:122-127
- Harvey, K., Kramlich, D., Chapmann, J., Parker, J., & Blades E., (2010). Exploring and evaluating five paediatric falls assessment instruments and injury risk indicators: An ambispective study in a tertiary care setting. J Nurs Manag,18:531-541.
- Helsley, L., McDonald, JV., Stewart, VT., (2010). Addressing In-Hospital "Falls" of Newborn Infants. The Joint Commission Journal on Quality and Patient Safety 36-7.
- Hill-Rodriguez, D., Messmer, P R., Williams, P D., Zeller, R A., Williams, A R., Woods, M, & Henry, M. (2009). The humpty dumpty falls scale: A case-control study. J Spec Pediatr Nurs January , Vol 14 No1: 22-32
- Hockenberry, MJ., & Wilson, D., (2007). Wong's Nursing Care of Infants and Children. Text and Study Guide Package
- Joint Commission International "Standard per gli Ospedali e per la Sicurezza del paziente" Standard – Ospedali e Sicurezza del paziente 2000 e 2011.
- Kimberly, H., Kramlich, D., Chapman, J., Parker, J., Blades, E., (2010). Exploring and evaluating five paediatric falls assessment instruments and injury risk indicators: an ambispective study in a tertiary care setting. J Nurs Manag,18(5):531-541
- Khambalia, A., Joshi, P., Brussoni, M., Raina,P., Morrongiello, B., & Macarthur, C., (2006). Risk factors for unintentional injuries due to falls in children age 0-6 years: a systematic review. Inj Prev, 12:378-385.
- Levene, S., Bonfield, G., (1991). Accidents on hospital wards. Arch Dis Child, 66:1047-1049.
- Monson, S A., Henry, E., Lambert, D K., Schmutz,N., & Christensen, R D., (2008). In-hospital falls of new-born infants: Data from a multi-hospital health care system. Pediatrics, 122(2): e277-e280.
- Morse, J., Faan, A., (2009). Preventing patient falls: establishing a fall intervention program. 2° Ed.Springer publishing Company.
- Neiman, J., Rannie, M., Thrasher, J., Terry, K., and Kahn, MG., (2011). Development, implementation, and evaluation of a comprehensive fall risk program. J Spec Pediatr Nurs, 16(2):130-139.
- Razmus, I., Wilson, D., Smith, R., & Newman, E., (2006). Falls in hospitalized children. Pediatr Nurs, 32(6):568-572
- Regione Lombardia – Direzione Generale Sanití n° 7295 del 22/07/2010 "Linee di indirizzo e requisiti minimi regionali per l'implementazione di un sistema per la prevenzione e la gestione del rischio caduta del paziente degente in ospedale o in RSA-RSD"
- Tung, T., Liu, M., Yang, J., Syu ,W., & Wu, H., (2009).Useful methods of preventing accidental falls from the bed in children at the emergency department. Eur J Pediatr, 1323-1336.
Riferimenti
Bagnasco, A., Sobrero, M., Sperlinga, L., Tibaldi, L., Sasso, L., (2010). Accidental falls in hospitalized children: an analysis of the vulnerabilities linked to the presence of caregivers. J Prev Med Hyg, 51:92-96.
Child Health Corporation of America Nursing Falls Study Task Force, (2009). Pediatric Falls: State of the science. Pediatr Nurs, 35(4):227-231.
Cooper, C L., & Nolt, JD. (2007). Development of an evidence-based pediatric fall prevention program. Jour Nurs Care Qual, 22(2):107-112.
Gill, AC., Kelly, NR. Prevention of falls in children. UpToDate. www.uptodate.com data ultimo accesso 01/06/2012
Graf, E., (2011). Magnet Children's Hospitals: Leading Knowledge Development and Quality Standards for Inpatient Pediatric Fall Prevention Programs. J Pediatr Nurs, 26:122-127
Harvey, K., Kramlich, D., Chapmann, J., Parker, J., & Blades E., (2010). Exploring and evaluating five paediatric falls assessment instruments and injury risk indicators: An ambispective study in a tertiary care setting. J Nurs Manag,18:531-541.
Helsley, L., McDonald, JV., Stewart, VT., (2010). Addressing In-Hospital "Falls" of Newborn Infants. The Joint Commission Journal on Quality and Patient Safety 36-7.
Hill-Rodriguez, D., Messmer, P R., Williams, P D., Zeller, R A., Williams, A R., Woods, M, & Henry, M. (2009). The humpty dumpty falls scale: A case-control study. J Spec Pediatr Nurs January , Vol 14 No1: 22-32
Hockenberry, MJ., & Wilson, D., (2007). Wong's Nursing Care of Infants and Children. Text and Study Guide Package
Joint Commission International "Standard per gli Ospedali e per la Sicurezza del paziente" Standard – Ospedali e Sicurezza del paziente 2000 e 2011.
Kimberly, H., Kramlich, D., Chapman, J., Parker, J., Blades, E., (2010). Exploring and evaluating five paediatric falls assessment instruments and injury risk indicators: an ambispective study in a tertiary care setting. J Nurs Manag,18(5):531-541
Khambalia, A., Joshi, P., Brussoni, M., Raina,P., Morrongiello, B., & Macarthur, C., (2006). Risk factors for unintentional injuries due to falls in children age 0-6 years: a systematic review. Inj Prev, 12:378-385.
Levene, S., Bonfield, G., (1991). Accidents on hospital wards. Arch Dis Child, 66:1047-1049.
Monson, S A., Henry, E., Lambert, D K., Schmutz,N., & Christensen, R D., (2008). In-hospital falls of new-born infants: Data from a multi-hospital health care system. Pediatrics, 122(2): e277-e280.
Morse, J., Faan, A., (2009). Preventing patient falls: establishing a fall intervention program. 2° Ed.Springer publishing Company.
Neiman, J., Rannie, M., Thrasher, J., Terry, K., and Kahn, MG., (2011). Development, implementation, and evaluation of a comprehensive fall risk program. J Spec Pediatr Nurs, 16(2):130-139.
Razmus, I., Wilson, D., Smith, R., & Newman, E., (2006). Falls in hospitalized children. Pediatr Nurs, 32(6):568-572
Regione Lombardia – Direzione Generale Sanití n° 7295 del 22/07/2010 "Linee di indirizzo e requisiti minimi regionali per l'implementazione di un sistema per la prevenzione e la gestione del rischio caduta del paziente degente in ospedale o in RSA-RSD"
Tung, T., Liu, M., Yang, J., Syu ,W., & Wu, H., (2009).Useful methods of preventing accidental falls from the bed in children at the emergency department. Eur J Pediatr, 1323-1336.