Trial of Proximity Alarms to Reduce Patient Falls

描述（由申请人提供）：近距离报警系统被推广为一种减少跌倒和减少医院使用物理约束的方法，但它们尚未经过严格的测试。该研究的目的是测试一种干预措施，在卫理公会大学医院（M-UH）对住院患者摔倒风险引入和实施近距离警报，该医院位于田纳西州孟菲斯市，是一家拥有652个床位的城市社区医院。该医院为不同的成年患者提供初级到三级护理。

DESCRIPTION (provided by applicant): Proximity alarm systems are promoted as an approach to reduce falls and decrease use of physical restraints in hospitals, but they have not been tested rigorously. The goal of the proposed study is to test an intervention to introduce and implement proximity alarms on the risk of falls in hospitalized patients at Methodist-University Hospital (M-UH), a 652-bed urban community hospital in Memphis, Tennessee. The hospital provides primary to tertiary care to a diverse adult patient population. We propose to test the intervention using a group randomized trial conducted on 16 25-bed general medical-surgical nursing units at M-UH. Nursing units will be randomized within blocks of 2 based on rates of falls that occur during an initial 3-month observation period. Over a 15-month intervention, 8 nursing units will be randomized to receive the alarm-based intervention, and 8 will utilize existing nursing care methods to minimize falls. Intervention units will receive an adequate supply of proximity alarm monitoring systems to apply to all patients considered by nursing staff to be at high risk for falls. An implementation team, consisting of a nurse-champion, geriatrician and biomedical instrumentation specialist, will train and conduct regular follow-up on intervention units to address technical issues related to use of the alarms. The primary outcome measure, patient falls, will be ascertained prospectively by a nurse-manager using a method we have developed to collect patient (e.g., orientation and postural blood pressure) and environmental data collected in a standardized manner. The primary aim of the study is to determine whether proximity alarm monitoring reduces falls. We have designed the study to test the hypothesis that patient falls will be 25% lower on intervention units compared to control units. The secondary aims are to determine whether proximity alarm monitoring reduces the use of physical restraints, or decreases patient care costs. This will be the first methodologically sound study to evaluate this promising approach to reducing falls in hospitals. Whether or not alarms successfully reduce falls, findings from this proposed study have the potential to widely impact purchasing decisions and clinical practice related to fall prevention in acute-care settings.