Project to Provide Folding Bed Facilities for Guardians to Improve the Quality and Safety of Care for Sick Children at Sirimavo Bandaranaike Special Children’s Hospital, Peradeniya, Sri Lanka

Background: The lack of proper sleeping arrangements for guardians in pediatric wards leads to patient falls, as bed rails are often taken down to make room for guardians who are in uncomfortable positions. Objective: To provide folding bed facilities for guardians in order to improve the quality and safety of care for sick babies at Sirimavo Bandaranaike Special Children’s Hospital, Peradeniya, Sri Lanka. Methods: The quality improvement initiative was implemented at Sirimabo Bandaranaike Special Children's Hospital from 2019 to 2023.Two wards (Ward 1 - Medicine, Ward 4 - Surgery) were each equipped with 50 folding beds (intervention group), while the corresponding two wards (Ward 2 - Medicine, Ward 10 - Surgery) continued to provide standard care (comparison group). The primary outcome measured was the annual patient fall rate, and the secondary outcome was caregiver satisfaction. Results: Intervention wards exhibited notable decreases in fall occurrences: Ward 1 experienced a 66.7% reduction (from 21 to 7 falls) and Ward 4 recorded a 70.0% decrease (from 10 to 3 falls) from 2019 to 2023. In comparison, the control wards showed negligible variation—Ward 2 showed a 20.0% rise (from 10 to 12 falls) while Ward 10 had a 27.3% reduction (from 11 to 8 falls). Altogether, the intervention group accomplished a 68.4% drop in falls, in contrast to a 13.6% decline in the comparison group. Satisfaction among guardians regarding folding bed arrangements reached 99%. Conclusions: Providing caregivers with folding beds significantly reduced the incidence of pediatric falls in the intervention wards and also increased caregiver comfort and satisfaction. Comparison services showed minimal improvement, highlighting the particular effectiveness of this intervention in promoting patient safety. This low-cost initiative has shown measurable improvements in patient safety and strong stakeholder acceptance.