Children's falls inside the inpatient setting: A qualitative study of parent perceptions and the implications for falls prevention messaging

To explore how parents understand their children's falls during hospitalization and how they perceive hospital interventions and messaging related to fall risk and prevention. Semi-structured interviews were conducted to explore parent-caregiver descriptions of their children's falls during hospitalization. Prospective purposive sampling was used to identify eligible participants. Interviews were conducted with the parent-caregiver who was present at the time of the fall event. Themes were coded both inductively and deductively using a constant comparative method. Twelve parent-child groupings participated. Three themes emerged: parental knowledge of risk, parent sense of threat to the identity of the child, and age differences in perception of level of controllability of risk. Falls prevention education is usually delivered as a straightforward presentation of generic factual information about risk factors, with the assumption that families need more information. Findings from this study challenge this approach. This study indicates that parent-caregivers have fairly high levels of knowledge about children's fall risks; parent-caregiver beliefs about the controllability of falls may differ based on age of the child; finally, as has been found in previous studies of adult falls, parent-caregivers may perceive hospital falls prevention measures as a source of potential threat to their child’'s already vulnerable social identity. Involving the parent-caregiver in the fall risk assessment and collaborative development of falls prevention interventions may increase family alliance with health advice and reduce the incidence of falls in hospitalized children. •Falls tend to occur in the presence of a parent-caregiver, yet their perspectives on fall risk are often not considered or incorporated into routine messaging about falls prevention in pediatric care settings.•Evidence indicates that health behaviors and responses to health advice are strongly influenced by parent mental representations of illness which also include their children’s unique identities.•Falls prevention education in pediatrics should be individualized, sensitive to what parent-caregivers already know and understand about their children's health and risk and differentiated based on the age of the child.