Pediatric Patient Safety

Pediatric Patient Safety: Falls in Pediatric Patients


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Concepts of Patients Safety

Patients’ safety is a multifaceted issue that requires attention from various stakeholders. As quoted in Gandhi et al. (2018), the Lucian Leap Institute (LLI, 2009) of the National Patient Safety Foundation identifies five fundamental concepts of patient safety. The elements include the revitalization of medical education, prioritizing on practitioner’s safety and motivation, engaging the consumer, and encouraging transparency. Gandhi et al. (2018) aver that before the identification of these ideals, the safety of patients is primarily hampered by the absence of an environment, which is founded on a culture that promotes constant improvements. These considerations should be accompanied by proactive predetermined actions that include plans for boosting the practitioner’s commitment. After all, patients’ safety is mainly dependent on the competence demonstrated by health care practitioners.

Definition of Safety

Safety in healthcare settings entails eliminating, minimizing, and mitigating the chances of harm to patients and other stakeholders. The World Health Organization (WHO, 2019) offered a concise description as the effective error prevention related to the provision of care that often endangers the lives, health, and well-being of patients. Safety has become a primary issue of concern since the provision of treatment and therapy, use of technology and the application of novel ideas and strategies in medicine have drastically increased the complexity of offering medical services. As therapeutic complications continue to rise, many cases associated with patient’s safety continue to increase often with dire implications.

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Importance of Pediatric Patient Safety

Children have an increased chance of experiencing safety issues in acute and emergency healthcare settings. Research reveals that almost 80% of all hospital visits are pediatric related. In addition, Mueller, Neuspiel, and Fisher (2019) found that treatment facilities, especially emergency units are ill prepared to handle medical emergencies for children, which consequently increases risk exposure. Such patients usually have unique difficulties, particularly in trauma and emergencies due to their profoundly different requirements compared to adults. In this regard, Mueller, Neuspiel, and Fisher (2019) insist that providers of pediatric should be knowledgeable about the language of children’s safety while becoming advocates of enhanced care services and policies that aim at minimizing child-related dangers. Besides, they should agitate for methods of eliminating avoidable risks in health care and adopt a safety-oriented culture in their professional settings.

Common Safety Issues in Pediatric

Many inpatient children are exposed to medical errors and other forms of danger. The differences between adults and child patients account for some of the most common issues in pediatric care safety. They include anatomical variations between adults and children, emotional reactions, as well as treatment and therapy dosages. Consequently, medical errors are common safety issues in health care and may include wrong-site surgeries and other surgical accidents, falls, burns, wrong transfusions, identity mistakes, and incorrect diagnoses. The implication is that a child’s demographics account for the elevated risks or harm in pediatric patients (Miller, Takata, Sturky & Neuspiel, 2011, p. 1200). For instance, the physical attributes that impact dosage calculated based on weight, the legal status of a minor, absence of a suitable decision maker, and developmental factors, such as mental or physical age, are all child-related characteristics that increase safety challenge among children in hospitals. Miller et al. (2011) also reiterated that despite the increase of practitioners awareness regarding issues of pediatric safety, it is still a major concern that adverse repercussions emanating from compromised safety standards have not declined as expected. Thus, more effort is required towards addressing the safety issues in pediatrics.

Critical Discussion

Safety Related Issues from Current

Children in hospitals typically experience a higher risk of falling and other safety issues due to developmental and non-developmental factors. In addition to being considerably more active, they may have compromised health, while the characteristics of their illness may also influence their risk of falling (Gonzalez, 2016, p. 236). Risks in pediatric health include dosing errors, delivery of medication, bloodstream infections related to the usage of a central line, urinary tract infection associated with catheter usage, infections in surgery sites, obstetrical issues, and injuries resulting from severe or minor falls (Miller et al. 2012). Multiple factors also explain pediatric safety challenges; for instance, practitioners’ in pediatric may lack adequate technical expertise in determining the right dosage for a specific weight.

The rationale for Chosen Issue: Pediatric Falls in Healthcare Settings

Falls are major safety issues for both children and adults. They pose considerable concern during children’s hospitalization and in other places. While more than half of all falls happen for teenagers under five years, for children over ten years, falls can be fatal or result in injuries that are more critical. Williams (2018) defines a patient fall as an unplanned descent to the ground that may result in injury. Moreover, the developmental stage of victims is critical in the evaluation of fall-related data. However, data on the effect of the stage of development on pediatric fall rates is scarce and anecdotal.

Critical Analysis of Measures taken to Overcome the Issue and Preventative Measures

Fall prevention among children should be personalized while strategies examined to ensure their continued effectiveness. Approaches for overcoming any pediatric safety risk should include simple interventions that can be adopted immediately as well as long-term solutions that will mitigate harm (Zhao, Bott, He, Kim, Park & Dunton, 2017). Personnel should also be ready to handle pediatric emergencies more effectively through comprehensive education, training, and supervision. In addition to sensitizing patients and their parents about fall prevention programs, these strategies should relate to the prevention of falls of children in hospitals. Solutions that can be integrated through technology should be prioritized if they have the potential to enhance patient safety.

Evidence-based interventions for error and fall risks have become critical for practitioners and researchers. The adoption of standardized strategies considerably reduces medical errors in pediatric care (Shahian, McEachern, Rossi, Chisari & Mort, 2017). Such an approach would be useful in reducing falls among children, especially if hospitals would develop and adopt a scale for fall risk assessment and mitigation strategies. For instance, some hospitals have adopted the adult Morse Fall Scale for children (Shahian et al., 2017). However, no scale exists that correctly identifies the risk of falling among children in hospitals.

Suggestions and Recommendations for Future Practice

Parents or guardians should play a significant role in the treatment of pediatric patients. Their participation should not only be procedural but also enhance treatment outcomes and reduction of harm. According to Murray, Vess, and Endlund (2016), the prevention of pediatric falls should be preceded by an accurate risk assessment followed by ongoing evaluation of a fall prevention program derived from a personalized intervention aligned with the patient-specific fall risks. Integrating these strategies can reduce the risk of falling among pediatrics or minimize the severity of an injury.


As it is evident from the analysis, patient safety is an essential factor in the provision of quality care. Children and adults have demonstrated different experiences and needs related to hospital risks. Safety is crucial and complicated for pediatric patients owing to their specific characteristics, including diverse developmental stages, which predispose them to risk of falling. Although safety issues identified for children are similar to those encountered by adults, they differ in terms of intensity, level of injury, underlying causes, treatment or intervention modalities, as well as preventative methodologies and approaches. Therefore, to address such challenges, patient-specific evaluation and intervention, as well as practitioners’s training and familiarization with pediatric safety, have emerged as crucial responses to children’s safety risks in treatment facilities.

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