Getting all on the same page to address pediatric fall prevention

May 03, 2019

A new study led by investigators at Mayo Clinic Pediatric Trauma Center finds a disparity between health care workers' perceived and actual leading cause of traumatic injury and injury-related emergency department visits for Minnesota children from birth to age 14 years.

Though falls are currently the state's No. 1 cause of such visits for children, many key personnel involved in prevention and treatment efforts have a different understanding of the top-ranking injury prompting care: Only 47% of trauma center staff and 25% of health department staff listed falls as the No. 1 cause of traumatic injury to children; 18% reported previous or current pediatric fall prevention efforts. The top barrier hindering prevention efforts was lack of sufficient resources.

This research was published in the March/April 2019 issue of Journal of Trauma Nursing.

Study focus

Kimberly (Kim) J. Lombard, Mayo Clinic Trauma Center injury prevention coordinator, and colleagues developed the study after noting a lack of fall prevention programs for children in the state.

"Though falls had surpassed motor vehicle crashes as the leading reason for hospital and emergency department visits, we weren't seeing a corresponding increase in fall prevention programming for kids," says Lombard. "We thought it was possible that the word had not gotten out fully to trauma and public health professionals about rates of childhood fall injuries in the state, and thus this was not a community outreach emphasis."

Terri A. Elsbernd, R.N., pediatric trauma coordinator at Mayo Clinic Trauma Center, also a study investigator, notes that the scientific literature shows a pervasiveness of fall prevention efforts targeting older adults, but little information exists about such programs for children, despite the prevalence of this mechanism of injury.

The team also wondered if there might be factors hampering implementation of relevant prevention programming for those who were aware that falls topped the list of Minnesota children's traumatic injuries.

Thus, the team developed a survey to measure the following for Minnesota trauma and public health staff:

  • Opinions on leading causes of pediatric injury in the state
  • Existing injury prevention programs for children
  • Data sources used for injury prevention outreach
  • Barriers preventing implementation of pediatric fall prevention programs
  • Existing partnerships between trauma centers and public health agencies

Scope of the problem of falls in children

A deeper dive into the pediatric fall issue in the state reveals that according to the Minnesota Injury Data Access System, 26,120 children visited Minnesota emergency departments with fall-related injuries. That's 38% of all pediatric visits that occurred due to injury. Centers for Disease Control and Prevention data indicate that falls also top the list of nonfatal injuries in children age 19 and under nationwide.

Children are at risk due to activities that vary by age, influenced by developmental stage. Lombard says infants are most at risk of falls from walkers, stairs and furniture; toddlers from playground equipment and windows; and older children from playground equipment as well. Boys are at particular risk of not only incidence of falls but also fatal falls.

Lombard indicates that the American College of Surgeons requires trauma centers to align injury prevention outreach with the top mechanism of injury identified in their service areas. As falls were first on Mayo Clinic's list, this was the key impetus propelling the research team's interest in this topic and future steps toward programming.

Next steps

Now with a better grasp on what is happening in Minnesota with respect to pediatric fall prevention, the researchers' injury prevention priorities deriving from the survey results are to:

  • Share survey results with trauma and public health professionals throughout the state to promote awareness of falls as the leading cause of injury in children
  • Build partnerships to enhance fall prevention efforts
  • Encourage data sharing among trauma centers and public health agencies
  • Engage in collective action with local and statewide partners to address pediatric fall prevention

With these priorities in mind, Lombard encourages trauma professionals to look at pediatric trauma data for their facilities. "Take a good look at your trauma registry for the last five to 10 years to see where you have been and are now regarding pediatric injury rates," she says. "My guess is that falls will be at the top of the list."

Lombard also suggests starting now to reach out to others in the community who might have an interest in improving the numbers for fall-related injuries in Minnesota's children. "We can't continue to ignore pediatric fall prevention," says Lombard.

For more information

Lombard K, et al. Building a case for pediatric fall prevention. Journal of Trauma Nursing. 2019;26:E2.

Fall prevention. Centers for Disease Control and Prevention.