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Updated: Aug 6, 2026
Design and Analysis for Fall Detection System Simplification
Published on: April 6, 2020
Hospital-based fall prevention interventions in paediatric patients: a systematic review and meta-analysis
Natalya Chagay1, Amin Tamadon2, Nadiar M Mussin3
1Department of Children Diseases No. 2, West Kazakhstan Marat Ospanov Medical University, Aktobe, Kazakhstan.
Insights
Hospital fall prevention interventions for children showed no significant effect on reducing falls. Multicomponent strategies combining risk assessment, staff education, and environmental changes were most effective, but tailored, evidence-based approaches are needed.
Area of Science:
- Healthcare safety research
- Paediatric patient care
- Clinical intervention effectiveness
Background:
- Falls in paediatric inpatients are a major safety concern, leading to extended hospital stays and increased costs.
- Effective hospital-based fall prevention strategies are crucial for improving patient safety and reducing healthcare burdens.
Purpose of the Study:
- To systematically review and meta-analyze the effectiveness of hospital-based fall prevention interventions for paediatric inpatients.
- To identify key components and contextual factors influencing the success of paediatric fall prevention programs.
Main Methods:
- Systematic review and meta-analysis of nine studies (quality improvement, experimental/quasi-experimental, retrospective).
- Searched Scopus, Web of Science, and PubMed databases for relevant paediatric fall prevention interventions.
- Assessed interventions including risk stratification, visual identifiers, surveillance, and caregiver education; employed independent reviewer screening and data extraction.
Main Results:
- Meta-analysis revealed no statistically significant association between hospital-based interventions and fall outcomes (OR=1.81), with high heterogeneity (I²=91.4%).
- Paediatric Fall Assessment Scale showed balanced diagnostic performance, while Humpty Dumpty Fall Scale had high sensitivity but limited specificity.
- Multicomponent interventions (risk assessment, caregiver involvement, staff education, environmental modifications) demonstrated the most consistent positive effects.
Conclusions:
- Current evidence suggests short-term interventions and lack of standardization limit effectiveness, necessitating tailored, evidence-based strategies.
- Integrating targeted high-risk patient approaches with universal hospital-wide safety measures is essential for effective paediatric fall prevention.
- Contextual factors like hospital infrastructure, staffing, and safety culture significantly influence intervention outcomes.
Background/Aims:
Falls among paediatric inpatients represent a significant safety concern, contributing to prolonged hospitalisations and increased healthcare costs. This systematic review and meta-analysis aimed to evaluate the effectiveness of hospital-based fall prevention interventions for paediatric inpatients.
Methods:
Nine studies, including quality improvement projects, experimental/quasi-experimental studies and retrospective analyses, were included after a comprehensive search of Scopus, Web of Science and PubMed databases. Interventions such as risk-stratified protocols, visual identifiers, enhanced surveillance and caregiver education were assessed. Two reviewers independently performed screening, data extraction and risk of bias assessment, and disagreements were resolved by consensus.
Results:
The meta-analysis (random-effects model with Hartung-Knapp adjustment) showed no statistically significant association between hospital-based interventions and fall outcomes (OR=1.81, 95% CI 0.57 to 5.77), with substantial heterogeneity (I²=91.4%, p<0.0001). Evidence on commonly used paediatric fall-risk screening tools was summarised narratively, indicating high sensitivity but limited specificity for the Humpty Dumpty Fall Scale and more balanced diagnostic performance for the Paediatric Fall Assessment Scale. Multicomponent interventions combining risk assessment, caregiver involvement, staff education and environmental modifications showed the most consistent effects, while single-component or short-term interventions were less effective. Contextual factors such as hospital infrastructure, staffing patterns and safety culture also appeared to influence outcomes.
Conclusions:
Despite promising results, short-term interventions and lack of standardisation highlight the need for tailored, evidence-based strategies. Our findings underscore the importance of integrating both targeted high-risk approaches and universal hospital-wide safety measures.
Prospero Registration Number:
CRD420251071227.
