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Smart Sock System Reduces Falls of Hospitalized Patients, Study Finds

Analysis  |  By Christopher Cheney  
   September 02, 2022

Hospital patients experience hundreds of thousands of falls annually, with increased length of stay and care costs, according to The Joint Commission.

A smart sock system significantly reduced patient falls at The Ohio State University Wexner Medical Center's Neurological Institute, according to a recent research article.

Hospital patients experience hundreds of thousands of falls annually, according to The Joint Commission. About one-third of those falls result in an injury, which lead to an average increase in length of stay of 6.3 days and an average care cost of $14,000.

The recent research article, which was published by the Journal of Nursing Care Quality, features data collected from 569 patients over a 13-month period. The patients were equipped with Palarum's PUP (patient is up) smart socks, which alert nurses when a patient attempts to stand up in their hospital room.

The study includes two key data points:

  • For patients enrolled in the study, there were no falls over 2,211.6 patient days
  • There were 5,010 alarms generated by the PUP socks, with only 11 false alarms (99.8% of alarms were generated by patient stands)

The smart socks system includes socks with pressure sensors that can detect when a patient tries to stand up. The system also includes a tablet for patient rooms, a local server, a monitoring device at the nurse station, and notification badges that are worn by nurses.

When the system detects that a patient is trying to stand up, an alert is sent to the notification badges of the three closest nurses. When one of the nurses enters the room, the alert is deactivated. If none of the three closest nurses responds within 60 seconds, an alert is sent to the next closest three nurses. If none of the nurses respond within 90 seconds, an alert is sent to all of the nurses wearing the notification badges.

Patients were enrolled in the study after a fall risk assessment, Tammy Moore, PhD, RN, associate chief nurse at the Neurological Institute, told HealthLeaders. "We base our fall risk assessment tool on known evidence of what creates a potential fall risk in hospitalized patients. We look at history of falling, altered mobility and/or gait, altered mental status, secondary diagnoses, medications, attachment to any equipment, and altered sensory or communication deficits. This assessment is done on admission and every eight hours or as needed."

Over time, nurses shed any hesitation they had over wearing the notification badges, she said. "While I am sure there may be staff that found the wearable badge a 'nuisance' in the beginning, I believe they began to realize the worth of wearing them and the ability to react sooner to their patient with this wearable device. Response times to respond to an alarm from a patient with the socks was an amazing feature of the product."

The cost of the PUP system is about $10 per day per licensed hospital bed, Chris Baker, co-founder and vice president of business development and marketing at Palarum, told HealthLeaders. The bed license is an all-inclusive price that covers all components of the system, including hardware, software, installation, training, and 24/7 support, he said.

"Our goal is to reduce hospital falls by a minimum of 20% to 25%, which would offset the cost of our system. Additional fall rate reductions would save the hospital significant costs as well improve the patient's hospital experience and outcomes," he said.

Related: Want to Decrease Falls? Here's How.

Christopher Cheney is the CMO editor at HealthLeaders.


In the study, none of the hospital patients equipped with the smart socks suffered a fall over a 13-month period.

The smart sock system includes notification badges worn by nurses. When a patient tries to stand up, the system notifies the three closest nurses wearing the badges.

The cost of the smart sock system is about $10 per day per licensed hospital bed.

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