The Bone Health Project

The Bone Health Project was initiated in 2009 with the support of a grant from the Children’s Hospital Foundation. The goal of the project was to identify those children at risk for fractures related to osteoporosis when admitted to hospital and to develop a handling protocol to ensure that children were handled safely during their hospital stay to prevent the possibility of fractures occurring. The development of the Bone Health Project was completed by an interdisciplinary working group. Each child admitted to Children’s Hospital is screened for risk of osteoporosis. This Bone Health Screening Tool is part of the initial Nursing assessment on admission. Based on this screening further intervention is determined by an algorithm that identifies assessment and treatment protocols. Those children determined to be at high risk for osteoporosis are placed on the “Handle With Care” protocol that includes proper signage at bedside, use of a stamp placed on lab and X-ray requisitions, and education of family regarding handling suggestions for home and school. Staff on the wards and in the labs and diagnostic imaging departments has received education regarding safe handling of children at risk. The “Handle with Care” protocols are also included as part of the lifting/transferring algorithms used in training hospital staff regarding safe patient handling techniques as part of Musculoskeletal Injury Prevention Training. This screening is now the standard of care on our inpatient units. The project has also been rolled out to out-patient clinics and the developed resources made available to community partners such as Home Care, school systems, and community pediatricians. In the 2 – 3 years prior to the implementation of this project there were three known cases of children sustaining fractures during their admission. Since implementation there have not been any documented cases of fractures identified. This project has raised awareness among the health care team of the need to evaluate bone health for those populations at risk for developing osteoporosis either due to their underlying health condition or related to the medications that they receive. This has resulted in bone health being a part of the overall medical assessment and treatment plan on a more consistent basis. The “Handle with Care” protocol has raised staff awareness of the need to use safe patient handling techniques when working with this population.