Highlights
- •The Humpty Dumpty Fall Scale is widely used to identify hospitalized children at risk of fall.
- •After analysis, several parameters were removed from the scale, and the scoring was updated.
- •The modified scale demonstrated a sensitivity of 84% and specificity of 57%.
- •These changes support clinical practice and improve fall prevention.
- •The updated tool is anticipated to provide a safer pediatric environment for the hospitalized child.
Abstract
Purpose
The purpose of this study was to identify potential modifications to the Humpty Dumpty
Fall Scale (HDFS) in order to enhance the accuracy of fall prediction in the pediatric
population, thus contributing to the safest possible environment for the hospitalized
child.
Design and methods
A secondary analysis of data collected by Gonzalez et al. (2020), including a total
of 2428 patients, was conducted for this study. Multiple logistic regression was used
to examine the relationship between each parameter of the HDFS (e.g., age, gender,
diagnosis, cognitive impairments, environmental factors, response to surgery/sedation/anesthesia,
and medication usage) and the outcome of fall status.
Results
After reviewing associations between HDFS parameters and fall risk, neither gender
nor medication use were found to be associated with fall risk. These two parameters
were removed from the scoring algorithms, and the HDFS was modified to a minimum score
of 5 and maximum score of 20, with a score of 12 or above indicative of high risk
of fall. The modified scale demonstrated a sensitivity of 84% and specificity of 57%.
Conclusions
These revisions are anticipated to help support clinical practice and improve fall
prevention, thus supporting a safer pediatric environment for the hospitalized child.
Keywords
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Article info
Publication history
Published online: July 28, 2022
Accepted:
July 19,
2022
Received in revised form:
July 15,
2022
Received:
May 25,
2022
Identification
Copyright
© 2022 Elsevier Inc. All rights reserved.
