Bed Alarms To Prevent Falls In Hospitals – Background Inpatient falls and subsequent injuries are among the most common hospital-acquired conditions with few effective methods of prevention.
Objective To assess the effectiveness of patient education videos and fall prevention visual cueing icons when added to bed exit alarms to improve fall and injury rates in acute medical-surgical inpatients .
Bed Alarms To Prevent Falls In Hospitals
Interventions A 4-min video was shown to patients by trained volunteers. Icons of risk factors and individual patient interventions were placed on patient beds. Beds were activated with built-in three-mode sensitivity output alarms for confused patients at risk of falling.
Cordless Bed Exit Monitoring System Alarm With Bed Pressure Sensing Pad
Main outcome measures The main outcome measure is the incident rate per 1000 patient days (PD) for patient falls, falls with any injury and falls with serious injury. The incidence rate ratio (IRR) for each measure was compared between January 2009 and September 2010 (baseline) with the January 2015–December 2015 (intervention) follow-up period.
Results Falls decreased by 20% from 4.78 to 3.80 per 1000 PD (IRR 0.80, 95% CI 0.66 to 0.96); falls with any injury decreased by 40% from 1.01 to 0.61 per 1000 PD (IRR 0.60, 95% CI 0.38 to 0.94); and falls with serious injury 85% 0.159 to 0.023 per 1000 PD (IRR 0.15, 95% CI 0.01 to 0.85). Icons were not fully implemented.
Conclusion We achieved the first known significant reduction in falls, falls with injury, and falls with serious injury among medical-surgical inpatients. Patient education and continued use of bed exit alarms were associated with large decreases in injury. Icons require more testing. Multicenter randomized controlled trials are needed to confirm the effectiveness of icon and video interventions and exit alarms.
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How To Prevent Patient Falls In 10 Steps
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Ranging from minor bruises and abrasions to more serious consequences such as lacerations, fractures, head injuries and even death.1 Age-adjusted death rates from falls have increased in recent years.1 Complications of falls during hospitalization are included in the Centers for Medicare and Medicaid Services Nonreimbursable Events List.2 More than one million patients fall in US hospitals annually, accounting for 85% of all acquired conditions in the hospital.3
The incidence of falls and injuries among hospitalized patients varies according to the characteristics of the unit 4 , with surgical patients at greater risk than intensive care patients. Medical-surgical units in the US report between 3.67 and 6.26 falls per 1,000 patient-days (PD).4 Twenty percent of falls in medical-surgical units result in some injury, while 2% result in serious injury.4 The acute care patient may be at increased risk for falls due to recently impaired mobility, side effects of medications, history of previous falls, frequent bathroom visits, and altered mental status, all in an unfamiliar environment.
As part of the American Patient Protection and Affordable Care Act of 2010, the Partnership for Patients encouraged acute care hospitals to test interventions to reduce patient falls and resulting injuries by 40%.5 A in late 2014, the Agency for Healthcare Research and Quality reported that hospital falls remained essentially unchanged from 2010 levels.6 The lack of significant injury reduction despite years of effort and the finding that efforts fall prevention programs may not be cost-effective7 have contributed to frustration among researchers, healthcare workers and patients at risk. To improve patient and hospital staff satisfaction and prevent unnecessary suffering, this study examines the efforts of one hospital’s medical-surgical units to educate patients and staff using videos, icons, and alarms.
Bed Alarm Systems For Fall Prevention With Elderly
An urban public safety network hospital with a linguistically diverse patient population found that rates of patient falls and injuries were trending upward. From 2009 to September 2010, fall prevention measures varied widely across the hospital. A “shooting star” magnet was placed on the door of the patient’s room. This was intended to communicate to the staff that the patient is at risk of falling. Unfortunately, staff found the star neither obvious nor indicative of particular interventions.8
Bed exit alarms could be requested, but this required additional steps. Patient failure to activate the call light was the most commonly cited explanation for the fall. Communication between nursing shifts and other units did not routinely include patient fall risk. Competing performance improvement priorities such as physical restraint and pressure injury reduction were also prioritized during this time.
In late 2010, VersaCare beds with built-in three-sensitivity bed exit alarms were introduced. Staff were alerted when patients moved in bed (more sensitive), sat on the edge of the bed (medium sensitivity), or got out of bed (less sensitive). This allowed nursing staff to go to the bedside before the patient had left. The new beds also feature a green indicator light that confirms the bed is in its lowest position with the alarm activated. The nurses were responsible for training their colleagues in the use of the new bed alarms; this training was anecdotally associated with a reduction in falls and injuries. Nursing managers reported that the early warning provided by the exit alarm allowed nursing assistants to be freed from close observation for only one patient at a time. Analysis of hospital falls by time of day found that injuries were more common among patients who fell during the night shift. Further improvement work focused on encouraging nursing staff to consider the use of the exit alarm for confused patients at risk of falls, particularly at night.
In addition to the continued use of the shooting star and tri-mode bed exit alarm, during the time period 2011 to 2014, the falls prevention team developed other interventions. Improvements include the documentation and analysis of falls, such as a “post-fall cluster,” collaboration with inpatient pharmacy to identify common medications that are risk factors for falls, and the development of a 10-min falls prevention video shown to all new non-physician clinical employees. during orientation. It was also common for nursing staff to ask a nursing assistant to closely observe people at risk of falls. However, the new measures have not lived up to expectations. Despite twice-daily screening of all medical-surgical inpatients with the Schmid screening tool, 9 it was found that communication of fall risk among staff was inconsistent and that patients were often unaware of their own risk Yellow wristbands indicating a high fall risk were applied to patients in the emergency room, but were not used after admission to a medical-surgical unit, as changes in patients’ conditions would require col ·place and cut the bracelet frequently. Finally, in 2014, hospital staff decided to implement a patient safety education program with videos in multiple languages delivered by volunteers and fall icons specific to risk factors.
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The hospital also selected pressure ulcer injury prevention to improve team performance during the same period. This provided the opportunity to retrospectively assess whether there was any change in the mobility of all medical-surgical patients. Physical restraints that prevent a patient from getting out of bed are also occasionally used in medical-surgical units. If falls were reduced with bedridden patients, there may have been an increase in pressure ulcer injuries and/or the use of restraints.
Can medical-surgical hospital falls and fall injuries be reduced by volunteer-administered video education and icons in addition to bed exit alarms?
There are few published randomized controlled trials of falls prevention programs in the acute care setting, and a recent meta-analysis of falls prevention found only a small reduction in falls.10 11 The evidence for reduction of injuries is even more elusive, with few studies proving significant. improvement of fall injuries.12 13
Prevention programs that have been widely implemented in acute care hospitals include screening patients with standardized risk assessments and addressing risk with interventions that include patient education, 10 14-17 warning signs risk of falls (icons)14 and exit alarms18-21 that indicate when a patient gets up without help.
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PubMed, Embase, and the Cumulative Index to Nursing and Allied Health Literature were searched using a variety of controlled vocabulary and keyword searches related to falls prevention, acute care, and injury. This comprehensive search revealed a gap: few studies of fall rates examined the effect of interventions on injury and injury severity. US hospitals appear to differ from other countries in terms of data collection standards and have different patient care environments (eg, open wards versus one or two patient beds per room), staffing characteristics and referral rates much higher or lower than Australia, 22 in the UK. , 23 24 Ireland25 and Singapore.26 Table 1 summarizes six recent studies from the United States on the prevention of fall injuries in acute inpatient medical-surgical units.
Two studies used exit alarms, 20 21 three included patient education,14 20 27 and two used icons or signs for visual signaling of fall risk. falls with any injury.13 One of the few randomized
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