Pediatric Fall Risk Assessment Tool Comparison and Validation Study

Published:February 27, 2018DOI:


      • I'M SAFE did not accurately predict falls in this study population.
      • Pediatric falls differ from adult falls in cause and type.
      • Pediatric patients have inherent risk for falls.
      • Sample size was insufficient to make formal conclusions on the Humpty Dumpty tool.



      Compare two pediatric fall risk assessment tools (I'M SAFE and Humpty Dumpty) used at the same organization to determine if one is better able to predict which patients fall.

      Design and Methods

      Retrospective data was obtained from patients admitted in 2014. Each patient who experienced a fall during hospitalization was matched with two non-fallers based on age and diagnosis. Logistic regression was performed to identify which tool more accurately determines fall risk and reliability testing was completed for the I'M SAFE tool.


      Over 22,000 patient files were extracted for this study. One hundred seventy-seven falls were identified, seventy-one of them were intrinsic. Of those patients who fell, the majority were assessed to be at high risk for falls. There were too few falls during the study period using the Humpty Dumpty tool to assess and make formal conclusions. The results for the I'M SAFE tool were opposite of what was expected and showed an increased risk for falls for patients who scored low risk using this tool.


      At completion of this study the data reflected that the I'M SAFE tool was not adequately predicting patients at greatest risk for intrinsic falls for this particular population.

      Practice Implications

      Further research on these tools is needed in other populations or across multiple sites. Additional work to adapt the tools may be necessary to better predict fall risk without over identifying high risk patients.
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