The staff of St. Jude Children’s Research Hospital wants you to know that certain situations and medical conditions can increase your child’s risk for falling. The risk for falling is greater in the hospital than it is at home because of your child’s growth and development, medicines, toileting needs, and use of different kinds of equipment.
It is important for you to know these risks and to take action to help prevent your child from being injured.
Patients with an increased risk of falling
- Those who have recently had a procedure that involved anesthesia or sedation (sleeping medicine)
- Patients with a mental status change or those who have become less alert or have less feeling in their feet because of their illness or treatments (such as those with a disease of the brain or nervous system or those receiving treatments such as some chemotherapy or radiation)
- Patients with a history of falling
- Patients with seizure disorders
- Patients who take certain medicines
- Patients who have problems walking such as those with stiff joints, tight muscles, or leg weakness, and those using canes, crutches, or wheelchairs
- Patients who have lost or gained weight over a short period of time
- Patients younger than 36 months of age when sleeping or playing in bed
The nursing staff will perform a Fall Risk Screening every 12 hours during the time your child is admitted as an inpatient. During the screening, the nurse will ask you questions to find out if your child is able to move around safely on his own. The staff will also check in with you in your inpatient room about every hour to ask if there is anything you or your child needs. Please let us know if we can help your child be safer.
If your child develops any of the risk factors above, the staff will take these precautions to help decrease the chance of your child falling:
- Inform all staff of your child’s increased risk by placing a sticker on your child’s identification (ID) armband and posting small notices on the door of your child’s inpatient room and on the medical record, which says your child is at higher risk for falling
- Providing a crib for your child if younger than 24 months of age
- Deciding the right size bed to use for your child if 25-36 months of age, based on your child’s height, potty training status, and the type of bed used at home
(To learn more about using the right bed for babies and toddlers and ideas for safe sleeping, see “Do You Know… Sleep Safety for Babies and Toddlers.”)
- Orient your child to the room and other areas of the hospital more often
- Move your child to a room closer to the nurse’s station (when needed)
- Provide and encourage help when your child is moving from the bed, chair, wheelchair, or toilet
- Even if your child is shy, encourage help when going to the restroom, especially when getting medicines for seizures, pain, nausea and vomiting, or receiving a lot of IV fluids
- Have your child use crutches, a wheelchair, a walker, or a cane if physical therapy has provided these items
- Not allow your child to play, stand, or “ride” on rolling stools, chairs, or IV poles
- Have family members stay with your child when you cannot be there
- Reduce clutter and clean up spills quickly in patient rooms
- Have your child wear shoes, slippers, or socks that resist slipping when out of bed or walking
- Keep side rails up on the bed and keep the bed in the lowest position
Older children and teens often are not as willing to call a staff member for help when moving from a chair to the bed or when moving to the toilet. Please explain to your child/teen that there is an increased risk of falling. To prevent falls that could cause serious injury, encourage your child to call for help each time there is a need to move around the room.
Other ways to prevent falls
If your child is an inpatient, these guidelines can help prevent falls:
- Make sure the nurse call light, bedside table, telephone, or anything else your child may need is within easy reach.
- Let the nurse know if you are leaving and your child is on falls precautions.
- All children who fall asleep outside their beds or cribs should be returned to their beds or cribs. Please do this before you get tired and are ready for sleep.
- Make sure the nurse call light works and your child knows how to use it.
- Ask the nurse or doctor how much activity is safe for your child at this time.
- Encourage your child to move slowly, especially when getting up from the bed and after receiving sedation.
- Have your child sit up on the side of the bed and wait to see how he feels before standing.
- If your child feels weak, lightheaded, or dizzy, he should ask for help before getting out of bed.
- Use a wheelchair or wagon if your child’s gait (walk) is unsteady after sedation or anesthesia.
- Your child should not lean on or use anything with wheels for support, such as an IV pole.
- Ask your child to call for you or the nurse when there is a need to get out of bed for any reason.
- Your child should not get out of bed at night alone. Patients who try to walk in the dark often fall.
- Bending over may cause your child to feel dizzy. Your child should not lean out of bed to pick up something off the floor.
- Your child should avoid wearing long nightgowns and robes that could cause tripping.
- Ask your child not to wait until he must hurry to the bathroom. Help him use the toilet often. If your child is too weak to go into the bathroom, ask the nurse for a bedside commode.
- If your child uses a cane, crutches, or a walker at home, he should do the same in the hospital.
- If foot braces have been prescribed, encourage your child to wear them.
- If your child wears glasses, they should be on before getting up to walk.
- Please tell the staff if you see a slippery area that could cause your child or someone else to fall.
- Talk to your child’s doctor, pharmacist, or nurse about medicines that could increase the risk of falls.
- Talk about preventing your child from falling while talking about your child’s care in the nursing bedside report.
If your child falls in the hospital
- After a fall, a nurse or doctor will examine your child. This exam will determine if your child needs closer monitoring and follow-up care after the fall.
- If your child bumps his head during a fall and complains of a headache or other pains, the staff will watch him closely for more serious signs of a head injury.
This document is not intended to take the place of the care and attention of your personal physician or other professional medical services. Our aim is to promote active participation in your care and treatment by providing information and education. Questions about individual health concerns or specific treatment options should be discussed with your physician.
St. Jude complies with health care-related federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex.
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