In an effort to reduce the number of patients who fall while hospitalized, the University of Nebraska Medical Center College of Allied Health Professions is conducting a study to compare patient monitoring systems to determine which system is more effective.
Each year, on average, about 3 percent of patients— three of every 100 patients — falls in a U.S. hospital. About one-third of the falls result in injury with an average cost of $14,000 per patient, said Katherine Jones, Ph.D., associate professor in the UNMC Division of Physical Therapy Education.
She said falls in hospitals are considered a preventable hospital-acquired condition even though patients may have gotten out of bed and fallen on their own. Excluding small critical access hospitals, hospitals must pay the expense to treat hospital-acquired injuries.
Dr. Jones, a physical therapist, said some of the reasons for falls are lower extremity weakness, medication side effects, the unfamiliar environment, urinary urgency and incontinence.
Some hospitals monitor patients via video, particularly those at high risk for falls.
“A typical system involves one person monitoring multiple screens to watch when patients start to get up,” Dr. Jones said. “The problem is, if the patient's already getting out of bed, the nurse may not be able to get there in time.”
In four hospitals in Nebraska, the team will compare a new patient monitoring system developed by Ocuvera, to interventions in each hospital. This may include interventions such as bed and chair pressure sensor alarms, assisted transfers and walking with a gait belt, mechanical lifts as appropriate, an alert sign indicating the severity of the fall risk, medication review by a pharmacist, evaluation by a physical therapist, toileting schedule, and supervised toileting.
With the help of Victoria Kennel, Ph.D., UNMC College of Allied Health Professions assistant professor and industrial/organizational psychologist, the team will determine the best way to train nurses to use the system.
The Ocuvera system captures the patient’s shape and movement to predict when a patient is likely to get out of bed. The system sends a signal to a nurse’s phone before the patient actually leaves the bed. The nurse can see the patient and decide how best to respond including asking the patient to stay in bed until the nurse or another nurse can help.
“We hope the system will keep patients safe, saving nurses’ time and reducing hospital costs,” Dr. Jones said. “A lot in the literature of fall risk reduction talks about it as a nursing quality problem. We want to frame it as an organizational quality problem so that everybody has a role in fall risk reduction.”
The study, which is scheduled to start in February and continue through May 2018, is funded by the state of Nebraska Research and Development Grant program, which funds research intended to produce innovations that might not result without state assistance.
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