Implementation of the humpty dumpty Scale-Pediatric fall risk assessment tool to promote quality care and prevent falls

To identify and implement an evidence-based pediatric fall risk assessment tool for use in pediatric department of Asian Institute of Medical Sciences.

The Iowa Model of Evidence-Based Practice to Promote Quality Care was used to guide the process. The Humpty Dumpty Scale (HDS) was choosen along with standard protocols that could be selected for two fall risk levels (Low and High). A Training Programme was developed for staff nurses who are working in pediatric units (PICU and wards) about falls and HDS, with planned time for discussion about any concerns in the implementation of HDS.

The Humpty Dumpty Scale was selected for implementation by Nursing Quality Team because it is evidence based and appeared to be conducive to implementation in the pediatric units. The training programme was presented to nurses working in pediatric units. Nurses expressed appreciation that they were consulted and trained and their feedback was incorporated into tool before it was implemented. Resources needed to implement recommended fall prevention protocols were identified and those were provided to the pediatric units before implementation of HDS.

The Iowa Model was a useful framework to select an evidence based tool and then engage nurses in the process of implementing evidence based practices. There was a significant improvement of knowledge among staff nurses regarding pediatric fall risk assessment after training programme. Ongoing training, monitoring, and follow up will determine this process results in appropriate risk assessment and prevention of falls in pediatric units.