Falls in hospital may be more likely to happen than falls in the home, because the hospital environment is unfamiliar to your child and it may take some time for them to feel comfortable in their new surroundings. They may also be affected by medication. In addition, hospitalisation causes stress and anxiety for many parents. Sometimes this can lead to distraction, which means that parents may overlook the safety precautions that they routinely take at home.

In the same way you keep your child safe at home, it is important to keep your child safe when they are in hospital. Half of the falls that occur in hospital happen when a parent is present, which is why parents and hospital staff should work together to prevent children from falling in hospital.

Assessing risk

All children are at risk of falling in hospital; however, some children have a higher risk than others because of their medical diagnosis. Falls cannot always be prevented, but risk assessments can ensure extra safety measures are put in place for children at greater risk of falls.

Nursing staff will assess your child's risk of falling each day they are in hospital, as their condition may change from day to day. If your child is identified as being at a high risk of falling, your nurse will develop a management plan with you to ensure you are aware of the extra safety measures required.

Your child will be provided the most appropriate bed for their age while in hospital. Patients aged two years and under will be cared for in a cot, while children older than two years will be cared for in a bed with side rails.

How you can help

There are many ways you can help prevent your child from falling in hospital.

• Help your child become familiar with their new environment (e.g. show them where the toilet is).
• Always supervise your baby, keeping hold of them when needed, when cot sides are down or when bathing or weighing them.
  
• If your baby is in an incubator, make sure the portholes are securely fastened and the door is closed when you are not directly attending to your baby.

Leaving your child unattended

• Show your child how to use the nurse call bell so they can call the nurse when you are not there. Ensure the bell is within your child's reach when you leave the room.
  
• Place other items that your child may need (e.g. walking frames, drinks or phone) within reach before you leave the room.
  
• Never leave your child unattended in the parent bed.
  
• Put cot sides or bed side rails up when leaving your child's bedside, even for short periods of time.
  
• Inform nursing staff when you are leaving your child's room.

Moving around

• Provide non-slip footwear for your child while they are in hospital (e.g. rubber-soled slippers).
  
• Help your child to walk to the toilet when appropriate.
  
• Keep floors clear of clutter such as toys and other belongings.
  
• Be aware of wet floors. Areas such as kitchens and bathrooms are prone to spills. If you notice a wet area, please let staff know immediately.
  
• Be sure to use safety belts when using wheelchairs, highchairs, strollers or infant seats.
  
• If your child has been given crutches, a walking frame, wheelchair or other equipment to help them move around, ensure they are using these items as they have been shown.
  
• If your child has been given a new medication, check with the nurse before getting your child out of bed.

What to do if a fall occurs

If a fall does occur, whether patient or visitor, you should inform nursing staff immediately. They will make the area safe and attend to the person who has fallen. Patients will be checked by the ward doctor. Nursing staff will complete an incident form to report all falls. This report will help to prevent future falls by identifying and removing the risks.

Key points to remember

• Help your child become familiar with their new hospital environment.
  
• Always supervise your baby, keeping hold of them when needed, when cot sides are down or when bathing or weighing them.
  
• Put cot sides or bed side rails up when leaving your child's bedside, even for short periods of time.
  
• Inform nursing staff when you are leaving your child's room, and place any items your child needs within reach.
  
• Provide non-slip footwear for your child while they are in hospital and be aware of wet areas.
  
• If a fall does occur, inform nursing staff immediately.

For more information

• Kids Health Info fact sheet: Safety: Preventing falls
• Kids Health Info fact sheet: Safety: Around the home
• Raising Children Network fact sheet: Preventing falls for babies and toddlers

Developed by The Royal Children's Hospital Nursing Services, in consultation with the Neuroscience, Rehabilitation, Surgery and General Medicine departments. We acknowledge the input of RCH consumers and carers.

Reviewed August 2018.

This information is awaiting routine review. Please always seek the most recent advice from a registered and practising clinician.

Kids Health Info is supported by The Royal Children’s Hospital Foundation. To donate, visit www.rchfoundation.org.au.