Nursing Diagnosis:

Risk for Falls related to unsafe stair environment and child's developmental stage.

Nursing Inference:

A five-year-old child's risk for falls on unsafe stairs is heightened by a combination of factors. Their
developmental stage, characterized by impulsivity and limited coordination, makes them prone to
accidents. The unsafe stairs, with their uneven steps, loose handrail, and inadequate lighting, create a
hazardous environment that further increases the risk of falls. The child's lack of awareness of these
dangers, as evidenced by their tendency to run on the stairs without caution, adds to the concern. This
situation necessitates a comprehensive approach to fall prevention, including education, environmental
modifications, and close supervision.

Nursing Goals:

Short-term goals:

- The child will demonstrate safe stair-climbing techniques by the end of the shift.

- The child will identify potential hazards in the stair environment by the end of the shift.

Long-term goals:

- The child will be able to safely navigate the stairs independently by the end of the week.

- The child's parents will implement safety measures to reduce the risk of falls by the end of the week.

INTERVENTIONS RATIONALE

Teach the child about the importance of using the This directly addresses the child's risk factors of
handrail and taking one step at a time. impulsivity and lack of attention. By emphasizing slow,
deliberate movements and using the handrail for
support, the child can learn to navigate the stairs safely.

Explain the potential dangers of running on the stairs. This intervention aims to increase the child's awareness
of the risks associated with running on the stairs. By
understanding the potential consequences of a fall, the
child may be more likely to exercise caution.

Encourage the child to use the stairs slowly and This reinforces the importance of deliberate
carefully. movements and reduces the risk of tripping or losing
balance.

Ensure adequate lighting on the stairs. Poor lighting can increase the risk of falls by making it
difficult to see the steps and potential hazards.
 Adequate lighting improves visibility and reduces the
risk of tripping.

Secure the loose handrail. A loose handrail provides no support and can actually
increase the risk of a fall if the child attempts to use it.
Securing the handrail ensures it is stable and offers
proper support.

Consider installing non-slip mats on the stairs. This intervention reduces the risk of slipping, especially
on smooth surfaces. Non-slip mats provide extra
traction and improve stability.

Remove any obstacles or clutter from the stairs. Clutter can create tripping hazards and obstruct the
child's path. Removing obstacles ensures a clear and
safe passage.

Closely supervise the child when she is using the stairs. This is a crucial intervention, especially given the child's
age and risk factors. Direct supervision allows for
immediate intervention in case of a potential fall and
helps reinforce safe stair-climbing practices.

Encourage an adult to accompany the child when going This provides additional support and supervision,
up and down the stairs. especially if the child is not yet confident in her ability
to use the stairs independently.

Work with the child's parents to implement safety This ensures that the intervention plan is integrated
measures at home. into the child's daily routine and that safety measures
are consistently applied.

Refer the family to a home safety specialist for a This ensures that all potential hazards are identified and
comprehensive assessment of the home environment. addressed, not just those related to the stairs. A home
safety specialist can provide tailored recommendations
for improving the overall safety of the home
environment.

Evaluation:

- Observe the child's progress in using the stairs safely.

- Assess the effectiveness of the implemented safety measures.

- Evaluate the child's understanding of stair safety.

- Monitor the child's behavior and identify any potential risk factors.