A system to detect fall occurrence and location in hospital settings

检测医院环境中跌倒事件和位置的系统

• 批准号: 10323706
• 负责人: Brian R Clark
• 金额: $ 97.34万
• 依托单位: BARRON ASSOCIATES, INC.
• 依托单位国家: 美国
• 财政年份: 2017
• 资助国家: 美国
• 起止时间: 2017-12-01 至 2023-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10323706
• 关键词: Accelerometer; Accreditation; Adhesives; Administrator; Adopted; Adoption; Adverse event; Algorithms; Altitude; Beds; Cessation of life; Charge; Choking; Cities; Clinical; Clinical Research; Cognitive; Computer software; Congresses; Data; Detection; Devices; Documentation; Elderly; Electronics; Encapsulated; Environment; Environmental Risk Factor; Equipment; Evaluation; Event; Failure; Fall prevention; Floor; Focus Groups; Freedom; Goals; Health Personnel; Health Professional; Healthcare; Height; Hospital Nursing; Hospitals; Hot Spot; Housing; Individual; Infrastructure; Injury; Inpatients; Institute of Medicine (U.S.); Institution; Insurance; Joint Commission on Accreditation of Healthcare Organizations; Laboratories; Laboratory Study; Lead; Legal; Legal patent; Length of Stay; Location; Measures; Medical; Medicare; Monitor; Muscle Weakness; Patient Monitoring; Patient risk; Patients; Pharmaceutical Preparations; Phase; Policies; Positioning Attribute; Prevention; Prevention Measures; Prevention program; Reaction Time; Reporting; Research; Response Latencies; Running; Safety; Site; Skin; Sleep; Small Business Innovation Research Grant; Sterile coverings; System; Time; Trauma; United States; United States Agency for Healthcare Research and Quality; Upper arm; Wireless Technology; base; data management; design; experimental study; fall injury; fall risk; falls; hazard; health care service organization; improved; instrument; instrumentation; intervention program; next generation; non-compliance; novel; phase 1 designs; programs; prospective; prototype; research and development; response; seal; sensor; tool; usability; wireless network

Project Summary/Abstract Problem Fall detection, assessment, and prevention is a challenging issue for healthcare institutions. Despite wide recognition as a considerable problem, fall-related injuries are the most frequently reported adverse events in hospital inpatient settings|up to 20% of patients fall at least once during their stay. According to the Agency for Healthcare Research and Quality reports, 30% to 51% of falls result in injury, and up to 44% of those injuries lead to death. In the United States alone, the number of inpatient falls exceeds 1 million per year, with elderly individuals being the most vulnerable. As a testament to its importance, fall research was listed as a top priority in the Institute of Medicine's report to Congress on national priorities. Diverse factors contribute to falls: patient factors (e.g., cognitive state, muscle weakness, medications), environmental factors (e.g., bed/toilet positioning, trip hazards), and institutional factors (e.g., poor respon- siveness to bed/chair alarms, inadequate fall assessment and prevention measures). Although hospitals employ programs to prevent falls, an essential component of a fall prevention program is accurate determination of fall events, as many falls are \unseen" and unreported. In their 2016 Claims Report, insurance company CNA stated that 66% of falls were unwitnessed and cited failure to monitor for falls in over half of closed legal claims. Alternative fall detection solutions have not been adopted in hospital settings due to poor fall sensitivity, high false-alarm rates, and lack of necessary supporting functions. Solution The body-worn FallCall system, proposed herein, will leverage powerful, novel sensing capabilities to provide robust fall detection and to report fall location without bothersome false alarms. The FallCall body-worn instrument will embody a miniature electronics package that is encapsulated in a disposable, hypoallergenic adhesive patch. The patch can be placed anywhere on the torso or upper arms to minimize interaction with other medical equipment or injury sites. The system will continuously monitor patients and issue a timely alert if a fall is detected, minimizing patient time on the ground, as well as injury assessment and treatment latencies. The FallCall system will allow patient location to be determined (including the room and oor of the hospital) using a reliable, robust wireless mesh network. Additionally, the FallCall system will have the capability to issue wander and inactivity alerts. The proposed system will be unique in its ability to objectively measure the response time of clinical sta when a fall occurs, and will be a key component in evaluating and improving fall prevention programs. Phase I Results The Phase I e ort built and evaluated the FallCall prototype in both a fall laboratory and real-world hospital setting using patients. The studies resulted in 100% of falls detected with zero false alarms. Location determination also achieved perfect accuracy. A formal usability study was conducted resulting in a grade in the top 5% based on normative data.

项目摘要/摘要 对于医疗机构来说，问题跌倒的检测、评估和预防是一个具有挑战性的问题。尽管 广泛认识到，跌倒是一个相当大的问题，与跌倒有关的伤害是最常见的不良事件 在医院的住院环境中|多达20%的患者在住院期间至少摔倒一次。根据该机构的说法 在医疗研究和质量报告中，30%到51%的跌倒导致受伤，其中高达44% 导致死亡。仅在美国，每年住院跌倒的人数就超过100万人，其中老年人 个人是最脆弱的。作为其重要性的证明，秋季研究被列为首要任务 在医学研究所提交给国会的关于国家优先事项的报告中。 导致跌倒的因素多种多样：患者因素(例如，认知状态、肌肉无力、药物)、 环境因素(例如，床位/厕所位置、旅行危险)和体制因素(例如，不良响应-- 床/椅警报不充分、跌倒评估和预防措施不足)。尽管医院雇佣了 预防跌倒的计划，预防跌倒计划的一个重要组成部分是准确确定 秋季事件，因为许多瀑布是看不见的，也没有报告。在2016年的索赔报告中，保险公司CNA 称66%的跌倒是无人目击的，并指出在超过一半的已结案法律索赔中没有监测跌倒。 由于跌倒敏感度较差、较高，医院尚未采用替代跌倒检测解决方案 误警率高，缺乏必要的辅助功能。 解决方案本文提出的人体佩戴的FallCall系统将利用强大的、新颖的传感功能来 提供强大的跌倒检测并报告跌倒位置，而不会造成麻烦的错误警报。FallCall身体穿戴 仪器将包含一个微型电子封装，封装在一次性、低过敏性的 粘性贴片。贴片可以放置在躯干或上臂的任何位置，以最大限度地减少与 其他医疗设备或损伤部位。该系统将持续监测患者并及时发出警报 如果检测到跌倒，最大限度地减少患者在地上的时间，以及损伤评估和治疗潜伏期。 FallCall系统将允许确定患者的位置(包括医院的房间和OOR) 使用可靠、健壮的无线网状网络。此外，FallCall系统将具有发布 漫游和不活动警报。拟议的系统在客观衡量反应的能力方面将是独一无二的 跌倒发生时的临床阶段时间，将是评估和改进跌倒预防的关键组成部分 程序。 第一阶段的结果是，第一阶段在秋季实验室和 使用病人的真实世界医院环境。这些研究的结果是，100%的跌倒被检测到没有错误警报。 位置确定也达到了完美的精度。进行了正式的可用性研究，结果是 根据标准数据，排名在前5%。