Development and Trial of a Paediatric Falls Screening Tool for Use in an Indonesian Context

*Natalia Ratna Yulianti  -  St. Elisabeth School of Nursing, Indonesia
Dianne Noviandini  -  Faculty of Math and Sciences, Satya Wacana Christian University, Indonesia
Kasmirah Kasmirah  -  Salatiga Local Public Hospital, Indonesia
Sri E. P. Sudarko  -  Salatiga Local Public Hospital, Indonesia
Ann Bolton  -  Charles Darwin University, Australia
Kobi Schutz  -  Charles Darwin University, Australia
Cheryl Hunt  -  Central Australia Health Service, Department of Health, Australia
David G. Arthur  -  The Aga Khan University, Pakistan
Received: 28 May 2019; Revised: 22 Oct 2019; Accepted: 18 Nov 2019; Published: 30 Dec 2019.
Open Access Copyright (c) 2019 Nurse Media Journal of Nursing


Citation Format:
Article Info
Section: Articles
Language: EN
Statistics: 392 308
Abstract

Background: Falls in the hospital have become an important issue internationally with numerous studies and assessment tools developed with a focus mainly on elderly adults. However, little has been written about falls in children in the hospital, which reveals evidence that falls and the sequels are significant problems.

Purpose: This study aimed to develop a culturally-based instrument for paediatric falls prevention.

Methods: In this action research study, participants, in this case, clinical nurses, joined the researcher in progressive problem-solving in two phases, starting with composing tool items based on the previous tools and research, then conducting validity and reliability tests. The instrument, the Paediatric Risk of Falls (PROF) Scale, was developed based on a literature review, contemporary models and the local context, and its content validity. In phase two, the staff of one local hospital participated in an education programme in the use of the tool, then were involved in the screening of all falls within two months on 156 paediatric patients in the paediatric ward in a local hospital in Indonesia. Data were analysed to examine the validity and reliability of the PROF Scale using Pearson Product Moment and Cronbach's alpha coefficients.

Results: Two of nine items related to medication and surgery were judged as not valid, possibly because of study parameters and technical problems in completing the items. One item on parental involvement, which was developed based on cultural practice in Central Java, was judged as a valid item. All items demonstrated acceptable reliability statistics.

Conclusion: The PROF Scale demonstrates satisfactory validity and reliability as a scale for assessing falls in pediatric settings in an Indonesian context, but needs to be tested in other settings to further test validity and reliability as well as its application and acceptability.

Keywords: Culture; Indonesia; pediatric falls; prevention; safety

Article Metrics:

  1. Black, A. D., Car, J., Pagliari, C., Anandan, C., Cresswell, K., Bokun, T., … Sheikh, A. (2011). The impact of ehealth on the quality and safety of health care: A systematic overview. PLoS Medicine, 8(1), 1–16. https://doi.org/10.1371/journal.pmed.1000387
  2. Choi, Y.-S., Lawler, E., Boenecke, C. A., Ponatoski, E. R., & Zimring, C. M. (2011). Developing a multi-systemic fall prevention model, incorporating the physical environment, the care process and technology: a systematic review. Journal of Advanced Nursing, 67(12), 2501–2524. https://doi.org/10.1111/j.1365-2648.2011.05672.x
  3. ICN. The ICN code of ethics for nurses. , Nursing ethics § (2012).
  4. Jamerson, P. A., Graf, E., Messmer, P. R., Fields, H. W., Barton, S., Berger, A., … Lunbeck, M. (2014). Inpatient falls in freestanding children’s hospitals. Pediatric Nursing, 40(3), 127–135. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/25134226
  5. Joint Commission International. (2012). International Patient Safety Goals. Retrieved from Joint Commission International website: www.jointcommissioninternational.org
  6. Maslow, A. H. (1943). A theory of human motivation. A Theory of Human Motivation, 50, 370–396. https://doi.org/10.4324/9781912282517
  7. Mason, Diana J., Isaac, Stephen L., Colby, D. C. (2011). The Nursing profession: development, challenges, and opportunities. In D. C. Mason, Diana J., Isaac, Stephen L., Colby (Ed.), Choice Reviews Online. https://doi.org/10.5860/choice.49-6322
  8. Miake-Lye, I. M., Hempel, S., Ganz, D. A., & Shekelle, P. G. (2013). Inpatient fall prevention programs as a patient safety strategy: a systematic review. Annals of Internal Medicine, 158(5 Pt 2), 390–396. https://doi.org/10.7326/0003-4819-158-5-201303051-00005
  9. Ministry of Health, R. of I. No Titlep. , Phys. Rev. E § (2011).
  10. Pauley, B. J., & Houston, L. S. (2014). HD Falls scale. 40(3).
  11. Polit, D. F., & Beck, C. T. (2012). Nursing research: generating and assessing evidence for nursing practice (9th ed.). Philadelphia: Lippinctot Williams Wilkins.
  12. Raeder, K., Siegmund, U., Grittner, U., Dassen, T., & Heinze, C. (2010). The use of fall prevention guidelines in German hospitals - A multilevel analysis. Journal of Evaluation in Clinical Practice, 16(3), 464–469. https://doi.org/10.1111/j.1365-2753.2009.01143.x
  13. Razmus, I., & Davis, D. (2012). The Epidemiology of Falls In Hospitalized Children. Pediatric Nursing, 38(1), 31–35. Retrieved from http://search.ebscohost.com/login.aspx?direct=true&db=a9h&AN=71827256&site=ehost-live&scope=site
  14. Roberts, C. (2012). Nurses’ Perceptions of Unaccompanied Hospitalized Children. Continuing Nursing Education, 38(3), 133–136. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/22908455
  15. Ryan-wenger, N. A., Kimchi-woods, J., & Erbaugh, M. A. (2012). Ryan-Wenger, 2012 #1197. 38(3), 159–168.
  16. The World Health Organization Europe. (2013). Patient safety. https://doi.org/10.4324/9781315113968
  17. Tzeng, H.-M. (2011). Nurses’ Caring Attitude: Fall Prevention Program Implementation as an Example of Its Importance. Nursing Forum, 46(3), 137–145. https://doi.org/10.1111/j.1744-6198.2011.00222.x