Patient falls are still the most common adverse event taking place in the long-term care facilities and acute care hospitals that sometimes result in injuring and even mortality. Every year on average 800.000 patients fall in the hospital (CDC, 2011). A fall may result in lacerations, fractures or internal bleeding, causing increased healthcare utilization and cost. According to the results of numerous researches, approximately one-third of all falls can be prevented (CDC, 2011).
Healthcare professionals in acute care hospitals have a complex set of goals when treating their patients. Apart from treating the patient and helping him recover his mental or physical functions, they are also responsible for keeping the patient safe. Thus, fall prevention should go along with other priorities and involve managing of the major underlying fall risk factors, such as problems with walking and transfers, confusion, medication side effects, frequent toileting needs, as well as optimizing the design, environment and equipment of the hospital. Today, when modern technologies become more and more used in the healthcare, there exists a number of sophisticated devices used for fall prevention in the hospital settings. Fall prevention technologies are gradually extending beyond simple notification. Today technology is used to screen for potential falls risk, or for prevention of the fall from occurring (Ferrari et al., 2012).
The aim of this paper is to introduce the concept of modern technologies, as an effective means of fall prevention and estimate its feasibility for a healthcare facility in terms of patient satisfaction and safety. The main objective of this paper is to evaluate outcomes which result from the implementation of such technology in a hospital setting.
Only 20 years ago, the choice of solutions for fall prevention was quite limited. However, with the advent of modern electronic technologies and software, today there appeared more options than ever before. The exist bed, chair and toilet alarm systems, sensor motion detection systems, gesture recognition interactive technologies, objected at notifying the staff, in case of an attempt to get up without assistance in a patient with increased fall risk (Ferrari, at al., 2012; Knight, et al., 2012; ‘Bed exit alarms’, 2004). Therefore these devices are potentially able to reduce falls by alerting personnel. Another potential benefit of alarm systems consists in reduction of the need for physical restraints.
One f the best-known type of fall prevention systems is a sensor pad, utilized over and under mattresses. It may be set for different levels of sensitivity, depending on the mobility of the patient. In case a patient moves out of the set area, the sensor pad creates an audible alarm. Sometimes alarms are connected to the light systems informing staff about the event. Some alarms allow change of volume; some are even able to create voice recordings. For example, a member of the patient family may record a voice message saying, “Mom, stay in bed’ to be used in case the patient tries to get up (‘Bed exit alarms’, 2004).
The gesture recognition interactive alarm uses capacitive proximity and pressure sensors to create a map of the sitting position of the patient, which is afterwards processed through the gesture recognition algorithms to find out whether the patient is attempting to stand up (Knight, 2008).
The choice of the most appropriate fall alarm depends on particular risk factors and patient needs, assessed and analyzed by the nurse. For instance, it makes no sense to install a bed sensor for a light weight patient. On the other hand, a choice of alarm with voice recording may be useful for a cognitively impaired patient, who responds well to familiarity. This patient may benefit from the use of a voice alarm with a recording from his or her spouse to help prevent falls.
The Effectiveness of falls prevention alarm systems in acute care hospitals is demonstrated through positive results of numerous studies and trials. Most of them estimate the benefit from these as sufficient, reporting that falls were reduced by 20- 60 percent. Shorr and colleagues (2012) call bed exit alarms to be a part of effective risk reduction strategies in healthcare facilities. According to Tideiksaar and colleagues, the outcomes of bed alarming systems implementation are positive for safely and satisfaction of patients. He observed clinical trend toward reducing the frequency of falls among older patients in hospitals with installed and actively used alarming systems (1993). The properly functioning system was reported to activate an alarm in all cases of patients transferring from bed, with nurses responding in a timely fashion to prevent bed falls. The system was not detected to produce any adverse effects on patients, nor interfering with the rendering of medical care. The alarm fall prevention systems were mostly well accepted by nurses, patients and their families.
Terry P. Haines and colleagues conducted the first large randomized trial confirming that alarms significantly reduce the incidence of falls in hospitalized elderly patients. The reduction in this case was reported to be 30 percent, which is a significant result not only for patients or their families, but also to hospital management, dealing with fall associated costs (2004).
The positive outcomes from implementation of modern fall prevention systems can be measured through estimating the following: positive effect on the care quality and efficiency, increase in patient and staff satisfaction and optimization in time utilization of the shift. Efficient alarming systems are able to improve productivity of nurses by giving them time, as they proactively anticipate and attend to the needs of the patients in case they are needed. However, modern technology can be effective only in combination with a warm and caring attitude of the hospital staff. Changing culture and understanding that falls may be very dangerous for the patients should be the first step on the way to implementing alarming systems and eliminating the problem. All the above mentioned data suggests that the alarm systems are effective in guarding against falls in patients of acute care hospitals and are a useful method of fall prevention.
- Centers for Disease Control and Prevention. (2011). Falls among older adults: An overview. Retrieved from http://www.cdc.gov/HomeandRecreationalSafety/Falls/adultfalls.html
- Ferrari, M., Harrison, B., Rawashdeh, O. Rawashdeh, M., Hammond, R. & Maddens, M. (2012). A pilot study testing a fall prevention intervention for older adults: Determining the feasibility of a five-sensor motion detection system. Journal of Gerontological Nursing, 38(1), 13-16.
- Haines, T.P, Bennell, K.L., Osborne, R.H. & Hill, K.D. (2004). Effectiveness of targeted falls prevention program in sub-acute hospital setting: randomized controlled trial. BMJ 328:676
- Knight, H., Lee, J.K. & Ma, H. (2008). Chair alarm for patient fall prevention based on gesture recognition and interactivity. IEEE Engineering in Medicine and Biology Society. 3698-701.
- Shorr, R.I., Chandler, M.M., Mion, L.C. Waters, T.M., Minzhao, L., Daniels, M.D. Kessler, L.A., & Miller, S.T. (2012) Effects of an Intervention to Increase Bed Alarm Use to Prevent Falls in Hospitalized Patients. Ann Intern Med. 157(10): 692’699.