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

自20世纪40年代以来，住院患者福尔斯一直是报告事件的最大单一类别，它们是发病率和死亡率的重要原因（Morgan等人，1985年）。国家健康与护理卓越研究所（NICE 2013）临床指南CG 161建议，所有65岁以上入院的患者和50 - 64岁之间有特定基础疾病的患者均被视为福尔斯高风险患者，并在入院时进行记录在案的福尔斯风险评估。拟议的研究假设，人们对“完成工作”的理解有限（Hollnagel等人，2015）关于这些任务，并且检查本次风险评估后使用的决策和风险缓解流程的证据较少。NICE临床指南文件161中的材料是一个动态主题，需要定期更新，当前更新（NICE 2019）建议在2024年发布的下一次更新之前需要考虑技术进步及其潜在贡献。跌倒预防警报器未被广泛使用，几乎没有研究证明其有效性。已经进行的研究通常无法描述所使用的警报类型，这可能会显著影响结果（卡梅隆等人，2018年）。现有的研究成果和大多数研究都来自简单的床椅出口警报器，没有数据收集或反馈机制来影响工作人员的风险评估和决策。研究人员将考虑由数字福尔斯预防警报提供的反馈数据是否不仅提供行为改变轮的“机会”元素（米吉等人，2011年），通过提供物理资源，以协助护士，但也允许他们通过提供真实的时间信息，将告知工作人员的风险评估process.Using混合方法的研究人员提出的方法来回答以下研究问题：-跌倒预防报警结果减少福尔斯/1000床日的病人入院24小时护理相比，标准的下降对策？选择使用防坠落系统对员工决策和风险缓解有何影响？工作人员和患者对防跌倒报警器的体验如何？对恢复和康复轨迹有什么影响？

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?