Researchers hope to learn whether small sensors attached to patients can help identify those at risk for falls.
Up to 1 million people in the United States fall in hospitals every year, says Agency for Healthcare Research and Quality, and when they do, the effects can be far-reaching. Patient falls are not only a safety issue, but a financial one as well.
According to the American Nurse Today, "The average hospital stay for patients who fall is 12.3 days longer, and injuries from falls lead to a 61% increase in patient-care costs."
In addition, if patients injure themselves after falling and their hospital stay is longer, hospitals run the risk of not being reimbursed, says Cindy Rishel, RN, PhD, OCN, administrator of nursing research and practice for the University of Arizona Medical Center-University Campus.
Despite using a falls risk model to identify which patients were at risk for falls, Rishel says her organization's falls rate—considered to be a nursing-sensitive indicator—was all over the map.
"I'm continually looking at the quality data for the entire organization," she says. "Our falls rate was not where we wanted it to be… we [couldn't] seem to get consistent improvement."
Other things they'd tried hadn't worked much either, such as bed alarms, which the hospital currently uses. In fact, University of Florida research from November 2012 showed that using bed alarms doesn't decrease patient falls and related injuries.
"When the bed alarm goes off, the patient's already out of the bed," Rishel says. Other ways of monitoring the patient—such as via video camera—were deemed too invasive, disrupting what little privacy hospital patients have, she says.
Rishel knew something more had to be done. That's why the hospital is now piloting something that she believes is a first: Whether small sensors attached to patients can help identify who is at risk for falls.
The small, wearable Zephyr BioModule sensors continuously track patients' skin temperature, physical activity, heart rate, respirations, and echocardiogram readings. More than 2 gigabytes of patient data is collected daily per sensor, and that data is then plotted against an algorithm that estimates fall risk.
"What it's measuring is motion in the patient, and it can tell us when the patient's at rest [or] when the patient is staring to move," Rishel says, adding that the sensors are very lightweight, attach to the patient with a regular electrocardiogram electrode attachment, and can be worn in the shower.
"The only thing the nurse has to do is… change it every 24 hours," she says.
The pilot began in September 2013, and will continue through September of this year. So far, 43 patients in the hematology/oncology unit have worn a sensor, and the researchers hope to get 100 patients to wear it by the time the pilot ends.
Rishel is one of the study's principle investigators, along with Bijan Najafi, PhD, M.Sc., University of Arizona associate professor of surgery, medicine and engineering, and director of the interdisciplinary Consortium on Advanced Motion Performance, or iCAMP. The manufacturer, Zephyr Technology loaned the hospital the sensors and other technology needed for the study, and other costs and staff are being provided by iCAMP.
Although the pilot is still underway, Rishel says early the data show promise.
"Early indications are in the few that have fallen you do see a pattern change," she says. "You see it on the data grab. You can see a change in the position of the patient from a supine to a prone position," for instance.
Although this part of the study is just for collecting data that might correlate patient activity with falls, Rishel says they hope to eventually expand the pilot to start alerting nurses when a fall seems about to happen.
"If we see this correlation in the data and the falls, we can link [the devices] to the phones that the nurses carry," she says. "We think it's going to prove that it's worth expanding this out."
The hospital might also expand risk assessments to include other factors that might indicate an increased falls risk, and make other changes based on the pilot data.
Rishel says that the pilot not only holds potential for the hospital and patients, but for nursing care, too.
"The nurses on the unit have been very supportive," she says. "They're very excited by the possibilities."
Alexandra Wilson Pecci is an editor for HealthLeaders.
