Patient falls are preventable, yet they occur in up to 3% of acute care hospitalizations. Of this substantial percentage, an estimated 30% of inpatient falls result in serious injury.1 A bedside fall, or an unexpected event in which a patient comes to rest on the ground, floor or lower level in the bed area, is the most common type of fall within a hospital. On top of this, a high percentage of these falls go unwitnessed.2
Patients are at risk of falling the moment they try to leave their bed. Hospitals are actively searching for ways to alert the caregiver before the patient leaves the bed, thus avoiding harm altogether. Common hospital initiatives designed to decrease the number of fall injuries include nursing hourly rounding to offer toileting assistance so that all items remain within the patient’s reach, and installing various bed exit alarms that are supposed to communicate to nurses in real-time to enable an immediate reaction to preventable falls. The problem with current fall prevention solutions is that they are not tailored to the needs of each particular patient and typically alert the caregivers only after the patient has already exited the bed.
As it stands, few hospitals have measured response times to alerts, and have no way of knowing how big of an impact a delayed reaction to a preventable fall can be. For example, pressure-based sensors, devices placed under the bed sheet, alarm only when the patient’s weight (pressure) is off the sensor, which may typically be much later than required and usually when the patient is already out of bed. Fall management products based on pressure sensors utilize local alarms and many times have no intelligent way to alert nurses about which patient in which room needs help and where they are located. Each time the patient moves false alarms may go off, which has led to many patients disabling these products out of annoyance, thus rendering them useless.
Real-time video monitoring has also been used in efforts to prevent patient falls. This method has proven quite effective, but it requires patient consent and not all patients or their families on a floor will agree to abide. This leaves nurses trying to monitor patients with different technology, and the gap for technology that alerts nurses to when the patient is trying to leave the bed still remains.
The Rise of Motion Based Monitoring
Medical technology is catching up, as the industry continues to innovate and provide the developments needed for preventable patient care. Motion based monitoring is emerging as an extremely effective way to alert a caregiver before a patient has left the bed, enabling real-time patient access as well as measurement to how effective the caregiver’s response time is. As reported by clinicians in Improved Outcomes and Reduced Costs with Contact-free Continuous Patient Monitoring on a Medical-Surgical Hospital3, the EarlySense preventative fall system substantially reduces patient falls. By detecting patient motion in a non-invasive and non-intrusive manner, nurses and caregivers obtain quick access to the patient and can be at their bedside before they have exited the bed.
This recent development begs the question: why is motion-based monitoring more effective than other fall prevention technologies? I would argue that technologies which support reliable and consistent motion detection in the healthcare setting (in hospital or in an alternative care location) is at its all time best. For example, we are able to use a piezo-electric sensor that detects the mechanical vibrations of the hearts cardio ballistic (motion) effect, respiratory patterns as well as patient motion. This very sensitive technology offers 6 levels of the bed exit sensitivity and allows the caregiver to personalize the sensitivity level according to the need of the patient and automatic adaptation to the unique needs at night. Never before have hospitals and caregivers been able to take such a personalized yet comprehensive approach to patient care, as it relates to preventing common bedside falls.
The key to preventing risky bedside falls, opposed to potentially showing up seconds too late, is the ability to know when they are about to occur. EarlySense’s Motion based monitoring is supported by a system solution that alerts nurses on mobile communication devices, central display stations and remote screens in prominent locations. Motion based monitoring enables adaptation to patients' unique needs at night when staff is limited, enabling the nurse to be at the bedside before the patient has exited the bed. A Rest Indicator was also developed to track a patients rest levels, and therefore prompt an early warning of patient’s potential attempt to exit the bed up to 50 seconds prior to the event/alert (research presented at Computing in Cardiology 2013 Conference). Because a systems based approach offers a level of sophistication to this problem that has not always been available to caregivers, reporting of how effective the caregivers may be to the potential bed exit of a patient becomes a powerful tool in establishing benchmarks for caregivers, and in driving new or modified behavior in an effort to achieve improved results. Trying to improve something, without being able to measure results can be a difficult task, with EarlySense, reports can be generated and reviewed in efforts to measure response times, and adjust as required.
Motion based monitoring supports a well-rounded preventative care approach in hospitals. We now have access to actionable information and patient data and the tools to manage it, empowering medical staff to identify critical situations and respond in a proactive manner, in hopes of preventing an adverse event from occurring. If we are going to drive and realize patient care improvements, we must unite on our goal to prevent adverse events—like the common bedside fall—from occurring in hospitals across the country.
1 Pearson, K.B. & Coburn, A.F. Evidence-based Falls Prevention in Critical Access Hospitals. 2011.
2 Australian Commission on Safety and Quality in Healthcare (ACSQHC). Preventing falls and harm from falls in older people: best practice guidelines for Australian community care. Canberra (ACT): Commonwealth of Australia, 2009.
3 Brown, HV & Zimlichman, E, Improved Outcomes and Reduced Costs with Contact-free Continuous Patient Monitoring on a Medical-Surgical Hospital Unit. 2010