Linkages between the safety of the hospital bed, patient falls and immobility

病床安全、患者跌倒和不动之间的联系

• 批准号: 7945920
• 负责人: Janice Margaret Morse
• 金额: $ 33.94万
• 依托单位: UNIVERSITY OF UTAH
• 依托单位国家: 美国
• 财政年份: 2011
• 资助国家: 美国
• 起止时间: 2011-09-30 至 2014-09-29
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7945920
• 关键词: Linkages; between; safety; hospital; bed

DESCRIPTION (provided by applicant): Fall intervention programs in hospitals and nursing homes are performing poorly, and many patients and residents still fall in hospitals and injure themselves. One aspect of the patient's environment that has not been systematically evaluated as a trigger for falls, is the hospital bed. In our pilot research, bed height, instability of the side rails, and the lack of a handhold for use when exiting the bed all contributed to fall risk. In this proposed study we will examine the relationships between bed height, the configuration of side rails, patient's physical characteristics and biomechanical forces that are exerted as the patient climbs in and out of bed. Sixty four participants, recruited from acute and long term care settings, will be videotaped as they interact with a bed that has been instrumented to measure patient strength requirements. Biomechanical, observational, and subjective participant data will be used to determine the optimal hospital bed height and side rail configurations to minimize the risk of falling and reduce the risk of injury. The biomechanical data will include joint torque during bed entry, exiting, and in-bed repositioning, as well as physical interactions between the patient, floor surface and hospital bed. Observed problems such as slips, balance checks, incomplete entry/exit, and near falls will be coded. Participants will provide a subjective assessment of their perception of fall risk associated with different bed heights and side rail configurations. We will also examine the side rail use for in-bed mobility. The ultimate goal of this research program is to develop design recommendations for a hospital bed that will enable the patient to enter the bed safely, to reposition themselves with minimal exertion, to stand with minimal effort at the bedside, and to move away from the bed with an optimally stable gait. This proposed research project addresses AHRQ's Patient Safety Mission to study the comparative effectiveness of important existing health care technologies, in this case the hospital bed. The development of a safe hospital bed will conservatively reduce bedside falls by 10%, thereby saving the healthcare system costs estimated at $1.5 billion per year in the prevention of injury by 2020. PUBLIC HEALTH RELEVANCE: Patient falls from the bed result in serious injuries. In this project we will explore the bed height and stability of the side rails as they contribute to the risk of falling. We will also examine patients' use of the side rail to assist with turning and moving about in the bed. The ultimate goal of this research program is to design a hospital bed that will assist the patient to enter the bed safely, to reposition themselves with minimal exertion, to stand with minimal effort at the bedside, and to move away from the bed with an optimally stable gait. The development of a safe hospital bed will conservatively reduce bedside falls by 10%, thereby saving the healthcare system future costs of $1.5 billion per year in the prevention of injury. This proposed research project addresses AHRQ's Patient Safety Mission to study the comparative effectiveness of important existing health care technologies, in this case the hospital bed.

描述（由申请人提供）：医院和疗养院的跌倒干预计划效果不佳，许多患者和居民仍然在医院跌倒并受伤。患者环境中尚未被系统评估为跌倒诱因的一个方面是医院的病床。在我们的试点研究中，床的高度、侧栏的不稳定性以及离开床时缺乏扶手都会导致跌倒风险。在这项拟议的研究中，我们将研究床高、护栏的配置、患者的身体特征以及患者爬进和爬下床时施加的生物力学力之间的关系。从急性和长期护理机构招募的 64 名参与者将被录像，他们与一张装有测量患者体力要求的仪器的床互动。生物力学、观察和主观参与者数据将用于确定最佳的病床高度和护栏配置，以最大限度地减少跌倒风险并降低受伤风险。生物力学数据将包括入床、出床和在床上重新定位期间的关节扭矩，以及患者、地板表面和病床之间的物理相互作用。观察到的问题，例如滑倒、余额检查、不完整的进入/退出以及险些跌倒，将被编码。参与者将对与不同床高度和侧栏配置相关的跌倒风险的感知进行主观评估。我们还将研究侧轨在床上移动中的使用。该研究项目的最终目标是制定医院病床的设计建议，使患者能够安全地进入病床，以最小的力气重新定位自己，以最小的力气站在床边，并以最佳稳定的步态离开病床。该拟议研究项目致力于 AHRQ 的患者安全使命，研究现有重要医疗保健技术（在本例中为医院病床）的相对有效性。安全病床的开发将保守地将床边跌倒事故减少 10%，从而到 2020 年为医疗保健系统节省估计每年 15 亿美元的预防伤害成本。 公共卫生相关性：患者从床上跌落会导致严重受伤。在这个项目中，我们将探讨床的高度和侧栏的稳定性，因为它们会增加跌倒的风险。我们还将检查患者使用护栏来协助在床上翻身和走动的情况。该研究项目的最终目标是设计一张病床，帮助患者安全进入病床，以最小的力气重新定位自己，以最小的力气在床边站立，并以最佳稳定的步态离开病床。安全病床的开发将保守地将床边跌倒减少 10%，从而为医疗保健系统未来每年节省 15 亿美元的预防伤害成本。该拟议研究项目致力于 AHRQ 的患者安全使命，研究现有重要医疗保健技术（在本例中为医院病床）的相对有效性。