Injury from falling is a real concern for hospital patients, particularly older adults. But pediatric patients are at risk, too, an unfortunate reality UNLV's Janet Dufek is working to better understand.
Dufek, a professor in the department of kinesiology and nutrition sciences, has teamed up with Nancy Ryan-Wenger, director of nursing research at Nationwide Children's Hospital in Columbus, Ohio, to examine incident reports detailing falls among children in pediatric-care facilities. Their goal is to examine both why falls occur and how best to quickly and accurately evaluate the damage done.
"Dr. Ryan-Wenger and I became mutually interested in combining our academic strengths and interests," Dufek says. "Hers is in pediatrics and standards of care, mine in applying mechanics to the problem of determining magnitude of injury following a fall in a hospital or clinic. I became interested in testing new approaches to identify and reduce pediatric patient falls and how to develop a risk model to evaluate the likelihood of serious injury following a fall."
With the assistance of a UNLV Faculty Opportunity Award, Dufek says she and Ryan-Wenger were able to amass the preliminary data they needed to convince outside funding agencies that their investigation was worthy of support.
"The primary purpose of this pilot study was to obtain data in support of an external grant application being prepared and submitted," she says, noting that the research team has already received a $10,000 grant from the American Nurses Foundation and is preparing a grant proposal for an Academic Research Enhancement Award from the National Institutes of Health. "Obtaining external funding would likely have been impossible without the faculty award support used to generate the pilot data."
She adds that the FOA was crucial to her collaboration with Ryan-Wenger. Dufek, a fellow with UNLV's Collaborative Research and Education (CoRE) program, is an advocate of interdisciplinary projects, but notes that each participant oftentimes must acquire new knowledge to conduct collaborative research.
"The Faculty Opportunity Award provided me the opportunity to work with Dr. Ryan-Wenger in an accelerated fashion to learn the new language of nursing and clinical care," says Dufek. "Our unique backgrounds have combined to generate ideas that neither of us would have independently developed."
Among these are recommendations intended to help pediatric healthcare providers do a better job in their initial assessments of injury severity. This is important, the researchers say, because no matter how careful physicians and staff may be, a small but significant number of kids will be hurt in falls each year.
"Ultimately," Dufek says, "we would like to reduce or eliminate the occurrence of pediatric patient falls in health care facilities. But that is likely an unrealistic goal. A more reasonable outcome is to develop an objective protocol to determine injury severity following a fall, one that would be used to inform standards of follow-up care."
Such a protocol is critical given the potential for further harming young patients with sometimes overly aggressive post-fall diagnostic evaluations.
"One of the undercurrents in our research is concern about exposing infants and young children to levels of radiation used in some diagnostic imaging techniques," says Dufek. "If we could more accurately determine fall severity using some form of quantitative evaluation, it is possible that children could be spared from exposure to unnecessary diagnostic radiation. We hope the long-term impact of this research has the potential to affect change in administrative policy and procedures in healthcare delivery and to reduce waste by eliminating unnecessary tests."
