Bed alarms not proven to prevent patient falls in hospitals, researchers say
(Medical Xpress)—Equipping hospital beds with alarms does not decrease patient falls and related injuries, according to University of Florida researchers and colleagues. The findings, published Nov. 20 in the Annals of Internal Medicine, cast doubt on the merits of the widely touted alarms as a patient safety tool.
"The idea that hospitals can magically eliminate the problem of falls by investing a lot of money and effort into bed alarms is not well-founded," said lead researcher Dr. Ron Shorr, a professor of epidemiology in the UF College of Public Health and Health Professions and College of Medicine and director of the Geriatric Research, Education and Clinical Center at the Malcom Randall Veterans Affairs Medical Center. "Does that mean bed alarms should never be used in hospitals? No—I think that alarms may have a use within the context of a well-developed fall prevention program."
Funded by the National Institute of Health's National Institute on Aging, the study adds to the sparse data that exist on the effectiveness of alarms in fall prevention in hospitals, and could help inform the design and application of fall-reduction strategies.
About one-quarter of falls among hospitalized patients result in injury, according to an analysis in the journal Clinics in Geriatric Medicine. Older adults are particularly at risk. Accidental falls lead to complications in 2 percent of hospital stays, according to various studies, including from the Agency for Healthcare Research and Quality. And falls extend hospital stays and raise treatment costs by more than $4,000 per patient, on average, according to an analysis in the American Journal of Medicine. In 2008, the Centers for Medicare and Medicaid Services stopped paying hospitals for excess costs incurred for treating injuries related to inpatient falls.
Bed alarms are thought to be useful in heading off falls by alerting staff when patients are attempting to move about unaided. And researchers acknowledge that some nurses point to alarms as a valuable tool based on their particular experiences.
Use of alarms also could potentially reduce the use of physical restraints, which have been shown to increase medical complications and, in some cases, actually raise the risk of falls and related injury. But despite widespread bed alarm use, a 2010 Cochrane Database of Systematic Reviews analysis found little evidence justifying the practice.
"The question is, if you're the chief nurse in a hospital, are you wasting your time buying these alarms for your units?" said Dr. David Oliver, an internationally noted geriatrics expert who is the national clinical director for Older People's Services in England's Department of Health. Oliver was not involved in the study.
To help answer that question, UF's Shorr and colleagues at the University of Tennessee and Vanderbilt University conducted a clinical study of almost 28,000 patients at Tennessee's Methodist Healthcare University Hospital. The 18-month study involved 349 patient beds in 16 general-medical, surgical and specialty units.
Units were randomly assigned to use commercial bed alarms or not. The alarm, made of weight sensors embedded into a flexible pad, could be placed on a bed, chair or toilet. When the patient's body broke contact with the sensor, a noise alerted the nurse. Patients did not know in advance whether they would be in units where alarm use was promoted, and neither did study personnel who assessed patient outcomes.
In one group, nurses were given educational materials and trained to use the bed alarms. Technical support providers also promoted use of the alarms and helped with setup and troubleshooting. In the second group, bed alarms were made available, but their use was not formally promoted or supported.
Among nursing units where bed alarm use was encouraged, the use of alarms was almost 36 times higher than among other units. But the increased usage did not translate into a decrease in the overall rate or number of falls, fall-related injuries or physical restraints used.
"That says to me that if we are relying on only one intervention to prevent falls, it's very unlikely to be successful," said co-author Lorraine Mion, the Independence Foundation professor of nursing at Vanderbilt University School of Nursing. "We're not saying don't ever use bed alarms—we're saying that if you think this intervention in and of itself is going to take care of the problem, then you're sadly mistaken."
Not counting alarms, both sets of hospital units in the study had various fall-prevention techniques in place. So because the study did not strictly contrast alarm use with the absence of any fall-prevention strategy, the results must be interpreted cautiously, the researchers said. Also, studies in which individual patients rather than hospital units are randomly assigned to alarm use might help clarify the role of alarms.
"I don't think from the paper you could say definitively that alarms don't prevent falls," said Oliver, also a visiting professor of medicine for older people at City University, London. "The question has not been settled. There needs to be more research. You can see the jury is very much out on the use of alarms."
Journal reference: Annals of Internal Medicine
Provided by University of Florida
- Not all smoke alarms created equal Apr 11, 2008 | not rated yet | 0
- Rate of falls in hospitals significantly reduced after use of intervention for fall prevention Nov 02, 2010 | not rated yet | 0
- Could new government regulations lead to increased use of physical restraints? Jun 03, 2009 | not rated yet | 0
- Researchers reveal formula for success in increasing smoke alarm use Dec 16, 2011 | not rated yet | 0
- Can in-hospital falls really be prevented? Jul 06, 2011 | not rated yet | 0
- Motion perception revisited: High Phi effect challenges established motion perception assumptions Apr 23, 2013 | 3 / 5 (2) | 2
- Anything you can do I can do better: Neuromolecular foundations of the superiority illusion (Update) Apr 02, 2013 | 4.5 / 5 (11) | 5
- The visual system as economist: Neural resource allocation in visual adaptation Mar 30, 2013 | 5 / 5 (2) | 9
- Separate lives: Neuronal and organismal lifespans decoupled Mar 27, 2013 | 4.9 / 5 (8) | 0
- Sizing things up: The evolutionary neurobiology of scale invariance Feb 28, 2013 | 4.8 / 5 (10) | 14
Classical and Quantum Mechanics via Lie algebras
Apr 15, 2011 I'd like to open a discussion thread for version 2 of the draft of my book ''Classical and Quantum Mechanics via Lie algebras'', available online at http://lanl.arxiv.org/abs/0810.1019 , and for the...
- More from Physics Forums - Independent Research
More news stories
People eating at fast food restaurants largely underestimate the calorie content of meals, especially large ones, according to a paper published today in BMJ.
Health 10 hours ago | not rated yet | 0
Don't doubt it when a woman harried by hot flashes says she's having a hard time remembering things. A new study published online in Menopause, the journal of The North American Menopause Society (NAMS), helps confirm with o ...
Health 12 hours ago | not rated yet | 0
The Senate has overwhelmingly rejected an amendment allowing states to require labeling of genetically modified foods.
Health 12 hours ago | not rated yet | 1
(AP)—McDonald's once again faced criticism that it's a purveyor of junk food that markets to children at its annual shareholder meeting Thursday.
Health 13 hours ago | not rated yet | 0
Can economic incentives such as gift cards, T-shirts, and time off from work motivate members of the public to increase their donations of blood?
Health 15 hours ago | not rated yet | 0 |
The British Menopause Society and Women's Health Concern have today released updated guidelines on Hormone Replacement Therapy (HRT) to provide clarity around the role of HRT, the benefits and the risks. The new guidelines ...
43 minutes ago | not rated yet | 0
(Medical Xpress)—Regulating the distribution of power in neurons is done by a system that makes the national electric grid look simple by comparison. Each neuron has several thousand mitochondria confined ...
11 hours ago | 4.8 / 5 (6) | 0 |
A brief visual task can predict IQ, according to a new study. This surprisingly simple exercise measures the brain's unconscious ability to filter out visual movement. The study shows that individuals whose ...
17 hours ago | 4.5 / 5 (10) | 1 |
Teams of highly respected Alzheimer's researchers failed to replicate what appeared to be breakthrough results for the treatment of this brain disease when they were published last year in the journal Science.
15 hours ago | 5 / 5 (1) | 2 |
Scientists at the National Institutes of Health report they have discovered in mouse studies that a small molecule released in the spinal cord triggers a process that is later experienced in the brain as ...
15 hours ago | 5 / 5 (2) | 0 |
Little is known about why asthma develops, how it constricts the airway or why response to treatments varies between patients. Now, a team of researchers at Weill Cornell Medical College, Columbia University Medical Center ...
15 hours ago | not rated yet | 0 |