Investigation into the sustained efficacy and experience of inpatient falls prevention alarms in acute care.

点击翻译按钮获取中文摘要

In-patient falls have consistently been the biggest single category of reported incidents since the 1940's, they are a significant cause of morbidity and mortality (Morgan et al., 1985). National Institute for Health and Care Excellence (NICE 2013) clinical guidance CG161 recommends that all patients admitted to hospital over the age of 65 and those with specific underlying conditions between the age of 50 and 64 are considered at high risk of falls and a documented falls risk assessment is undertaken on admission. The proposed research hypothesises that there is limited understanding about 'Work as Done' (Hollnagel et al., 2015) in regard to these tasks and less evidence examining the decision making and risk mitigation processes being utilised following this risk assessment. The material within NICE Clinical Guidance document161 is a dynamic topic that requires regular updating and the current update (NICE 2019) recommends that technological advances and their potential contribution need to be considered before the next update which is due to be published in 2024.Fall prevention alarms are not widely used and there is little research to demonstrate their efficacy. Research that has been conducted often fails to describe the alarm type utilised which can significantly impact results (Cameron et al., 2018). The outcomes and most of the available research is derived from and conducted on simple bed-chair exit alarms with no data collection or feedback mechanism to influence staff risk assessments and decision making. The researcher would look to consider whether the feedback data provided by a digital falls prevention alarm not only provides the 'opportunity' element of the Behaviour Change Wheel (Michie et al., 2011), by providing a physical resource to assist nurses, but also allows them to effect change by providing real time information that will inform the staff member's risk assessment process.Using a mixed methods methodology the researcher proposes to answer the following research questions:-Do fall prevention alarms result in a reduction in falls/1000 bed days in patients admitted to 24hour care compared with standard fall countermeasures? How is staff decision making and risk mitigation affected by the option to use a fall prevention system? What are the staff and patient experience of fall prevention alarms? What is the impact on recovery and rehabilitation trajectories?