Abstract
BackgroundFalls in hospitals are common, resulting in injury and anxiety to patients, and large costs to NHS organisations. More than half of all in-patient falls in elderly people in acute care settings occur at the bedside, during transfers or whilst getting up to go to the toilet. In the majority of cases these falls are unwitnessed. There is insufficient evidence underpinning the effectiveness of interventions to guide clinical staff regarding the reduction of falls in the elderly inpatient. New patient monitoring technologies have the potential to offer advances in falls prevention. Bedside sensor equipment can alert staff, not in the immediate vicinity, to a potential problem and avert a fall. However no studies utilizing this assistive technology have demonstrated a significant reduction in falls rates in a randomised controlled trial setting.Methods/DesignThe research design is an individual patient randomised controlled trial of bedside chair and bed pressure sensors, incorporating a radio-paging alerting mode to alert staff to patients rising from their bed or chair, across five acute elderly care wards in Nottingham University Hospitals NHS Trust. Participants will be randomised to bedside chair and bed sensors or to usual care (without the use of sensors). The primary outcome is the number of bedside in-patient falls.DiscussionThe REFINE study is the first randomised controlled trial of bedside pressure sensors in elderly inpatients in an acute NHS Trust. We will assess whether falls can be successfully and cost effectively reduced using this technology, and report on its acceptability to both patients and staff.Trial RegistrationISRCTN trial number: ISRCTN44972300.
Highlights
Falls in hospitals are common, resulting in injury and anxiety to patients, and large costs to NHS organisations
Over 200,000 falls were reported to the National Patient Safety Agency's (NPSA) National Reporting and Learning System (NRLS) in the 12 months from September 2005 to August 2006, with falls data being reported from 98% of organisations providing inpatient services [2]
Main research hypothesis The hypothesis to be tested is that the use of a pressure sensor alert system, incorporating a radio-paging alerting mode to alert staff to patients rising from their bed or chair, can decrease the number of bedside falls, in older people hospitalized in an acute care setting
Summary
Falls in hospitals are common, resulting in injury and anxiety to patients, and large costs to NHS organisations. More than half of all in-patient falls in elderly people in acute care settings occur at the bedside, during transfers or whilst getting up to go to the toilet. There is insufficient evidence underpinning the effectiveness of interventions to guide clinical staff regarding the reduction of falls in the elderly inpatient. In-patient falls result in injury and anxiety to patients and large costs to NHS organisations, including the costs of treating injuries, increased hospital stay, complaints and litigation [3,4,5]. People with dementia are more likely than those without it to require hospital admission, and are at least twice as likely to fall [7,8,9]. Up to 30% of in-patient falls occur during the first 48 hours of the patients' admission and 75% of in-patient falls occur in the first two weeks of hospital stay [7,10,11]
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