The revised Humpty Dumpty Fall Scale: An update to improve tool performance and predictive validity.

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.

Nurses' job satisfaction, stress, and recognition in a pediatric setting setting.

PURPOSE: The purpose of this study was to identify a set of factors that describes nursing satisfaction in the pediatric setting. METHODS: An exploratory descriptive design was used. Surveys were distributed to all nurses employed at a children's hospital in the Southeast. The survey included: nursing satisfaction, organizational work satisfaction, job stress, and nurse recognition scales. Two hundred and forty-nine out of 534 pediatric nurses (46%) responded. Data were analyzed using factor analysis and correlation. FINDINGS: The results of this survey demonstrated that several factors predict pediatric nurses' job satisfaction and organizational work satisfaction. These factors include: pay, time to do the nursing care, confidence in one's ability, and task requirements. A relationship among nurses' job satisfaction, organizational work satisfaction, job stress, and recognition in the pediatric setting was also found. Nurses with more years of experience and longevity on the unit and at the hospital had more confidence, showed less concern about time demands, and were less concerned about pay and task requirements than younger nurses. Job stress correlated significantly and inversely with age, years as a nurse, and years in the organization. Older nurses were more satisfied with recognition they received than their younger counterparts. CONCLUSIONS: The findings of this study support the need to focus on programs to increase the confidence of novice nurses, improve institutional nursing recognition for all levels, enhance communication at all levels of the organization, and maintain competitive compensation.