Thursday, September 29, 2016 From PTJ: Pediatric Rehab Unit Takes First Steps Toward Falls Prevention When the management team of one hospital’s pediatric rehabilitation unit sought to decrease the number of falls among its patients, they found little in the way of guidance. So they got to work: after scouring the research, they developed a unique falls prevention program called “Red Light, Green Light” that resulted in greatly reduced falls among these patients. The program is described in detail in an article e-published ahead of print in Physical Therapy (PTJ), the scientific journal of APTA. Most falls prevention programs are centered around older adults. But according to authors, 61% of falls among children are “anticipated physiologic falls”—in short, falls that could have been predicted using a falls risk assessment tool. Of those pediatric falls that caused injuries, most were due to “family inattentiveness” or “environmental/equipment factors.” So, the interdisciplinary team designed the program to educate both staff and family members who are present when the child is transferring or ambulating. Before the program, the unit experienced 8.84 total falls per 1,000 patient days. By 2014, that had decreased to 1.79 per 1,000 patient days. In addition, the rate of falls where family members were present was cut in half. The success of the program was due in large part to its interdisciplinary design. After a functional assessment by a physical therapist (PT), the PT trained individual family members on safe transfer or ambulation for their child. The family members then demonstrated the transfer or ambulation assistance. If they did so successfully, they were given a “green light” for that activity. If the family members could not perform the activity safely, or if the patient was too “physically challenging, impulsive or agitated, or medically unstable,” write the authors, the PT assigned a “red light” status. Occupational therapists were involved in assigning status for bathing and toileting transfers. Status was recorded on an internal communication form so that nurses could enforce it among families and make PTs aware if the families were not adhering to safe techniques. Families were reeducated if they were not adhering to the instructions or needed more explanation. All staff also received mandatory training on falls risks, prevention, safe transfer techniques, and other related topics. Authors of the PTJ article believe that the program's success is also linked to the way it approaches falls more comprehensively, writing that "this program goes beyond just fall risk identification, as it adds caregiver education, fall prevention structured rules and restrictions, and consistent follow-through and updates as progression occurs." Research-related stories featured in PT in Motion News are intended to highlight a topic of interest only and do not constitute an endorsement by APTA. For synthesized research and evidence-based practice information, visit the association's PTNow website.