Call to Action: Addressing Pediatric Fall Safety in Ambulatory Environments.

BACKGROUND: Pediatric falls in the ambulatory environment are a patient safety concern. Historically, fall safety efforts have focused on inpatient settings and are not transferrable to ambulatory environments. Minimal research and absence of ambulatory-specific guidelines from regulatory and global benchmarking bodies contribute to the void of knowledge. Consequently, there has been minimal progress in developing fall reduction strategies for the ambulatory environment. PURPOSE: To review research evidence and findings from environmental assessments that included interprofessional stakeholder feedback to make recommendations for improving fall safety in the pediatric ambulatory environment. METHODS: Implementation science was employed in two large pediatric quaternary hospitals to identify existing gaps and provided the foundation for translation of findings in the development of fall safety practice recommendations in the ambulatory environment. RESULTS: Recommendations from the findings included identified barriers and tangible interventions within three broad categories: equipment and furniture, environment, and people. Purposeful inclusion of all areas in the ambulatory environment, integration of high reliability concepts, and partnering with parents were identified as pertinent factors associated with these recommendations. CONCLUSION: This call to action recognizes the importance of utilizing an evidence-based approach for improvement and provides a framework for conducting an environmental assessment, which is an essential starting point to improve fall safety in the pediatric ambulatory environment. Guidance and support from research, regulatory and collaborative bodies, and healthcare organizations remains a critical need in improving fall safety.

Knowledge and beliefs about genetics and smoking among visitors and staff at a health care facility.

OBJECTIVES: The primary purpose of this study was to describe individuals' knowledge and beliefs about genetics and smoking. Secondary purposes were to describe (a) differences in knowledge and beliefs based on smoking status, gender, and education and (b) relationships among perceived genetic predisposition for smoking, background characteristics, and knowledge and beliefs about genetics and smoking. Because genetics influences smoking, genetic information will likely be used to individualize future cessation treatment. DESIGN: Questionnaire data were collected about knowledge and beliefs about genetics and smoking, smoking history, and demographics from visitors and staff at a nursing care facility. Data were analyzed with bivariate statistics and logistic regression. SAMPLE: Participants (N=92), ages 19-82, were classified by smoking status. RESULTS: Participants had little knowledge about genetics and smoking or mechanisms of heredity. Most did not believe that genetics caused smoking or influenced cessation. Predictors of perceived genetic predisposition for smoking were smoking status (current/former smoker), education (