Hospital-based fall prevention interventions in paediatric patients: a systematic review and meta-analysis

Natalya Chagay, Amin Tamadon, Nadiar Maratovich Mussin, Svetlana Kim, Ramazon Safarzoda Sharoffidin

2026

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DOI 10.1136/ip-2025-045897
Data confidence 70 medium
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Abstract

BACKGROUND/AIMS: Falls among paediatric inpatients represent a significant safety concern, contributing to prolonged hospitalisations and increased healthcare costs. This systematic review and meta-analysis aimed to evaluate the effectiveness of hospital-based fall prevention interventions for paediatric inpatients. METHODS: Nine studies, including quality improvement projects, experimental/quasi-experimental studies and retrospective analyses, were included after a comprehensive search of Scopus, Web of Science and PubMed databases. Interventions such as risk-stratified protocols, visual identifiers, enhanced surveillance and caregiver education were assessed. Two reviewers independently performed screening, data extraction and risk of bias assessment, and disagreements were resolved by consensus. RESULTS: The meta-analysis (random-effects model with Hartung-Knapp adjustment) showed no statistically significant association between hospital-based interventions and fall outcomes (OR=1.81, 95% CI 0.57 to 5.77), with substantial heterogeneity (I²=91.4%, p<0.0001). Evidence on commonly used paediatric fall-risk screening tools was summarised narratively, indicating high sensitivity but limited specificity for the Humpty Dumpty Fall Scale and more balanced diagnostic performance for the Paediatric Fall Assessment Scale. Multicomponent interventions combining risk assessment, caregiver involvement, staff education and environmental modifications showed the most consistent effects, while single-component or short-term interventions were less effective. Contextual factors such as hospital infrastructure, staffing patterns and safety culture also appeared to influence outcomes. CONCLUSIONS: Despite promising results, short-term interventions and lack of standardisation highlight the need for tailored, evidence-based strategies. Our findings underscore the importance of integrating both targeted high-risk approaches and universal hospital-wide safety measures. PROSPERO REGISTRATION NUMBER: CRD420251071227.