A unique wireless sock monitoring device, developed by nurses at The Ohio State University Wexner Medical Center, was found to lower fall rates among “fall-risk” patients receiving care at Ohio State’s Brain and Spine Hospital. In fact, over 2,211.6 patient-days of the study, none of the patients who were on a fall-risk regimen fell while donning the socks.
The findings of the study, which examined the efficacy of Palarum’s PUP (Patient is Up) Smart Socks, were posted online in the Journal of Nursing Care Quality.
During the 13-month study period, information was gathered on 569 patients who were admitted to the neurological and neurosurgery units of a major academic medical facility. Stroke, orthopaedics, neurosurgery, general neurology, and epilepsy are areas of expertise for these units. The COVID-19 pandemic forced an early stop to the trial, which had been scheduled to enrol 2,500 patients.
5,010 safety occurrences (alarms) connected to the system occurred throughout the study period. 11 false alarms were reportedly reported, meaning 4,999 safety incidents (or 99.8%) were indeed true patient stands, according to Moore.
Nurses evaluated patients’ fall risk scores upon admission to the hospital using the hospital’s assessment instrument. No other fall prevention equipment, such as chair or bed alarms or TeleSitter, was used for these patients. All trial participants received the socks until discharge or removal from the fall risk protocol.
The safety system is made up of interconnected gadgets with sensors that communicate data over a wireless network and socks with pressure sensors that detect when a patient is attempting to stand up. According to Chris Baker, co-founder and vice-president for business development at Palarum, the system also comprises an in-room tablet for every patient room, a local server, a monitoring device at the nurses’ station, and “Smart Badge” alerting devices worn by the nurses.
The technology notifies the three nurses it deems to be closest to the alarmed room through their badges when the socks detect an attempt to stand up. The warning is immediately turned off when a nurse with a badge enters the patient’s room. The alarm is escalated to the next three nearest nurses if none of them enter the room during the first 60 seconds. The system sends out a “all call” to all Smart Badges logged into the alarming unit if no one replies within 90 seconds, according to Baker.
“Due to the rapidly ageing population, it is anticipated that the proportion of hospital patients who are at higher risk of falling will significantly rise. It is crucial to find better strategies to prevent our patients from falling while hospitalised, according to research co-author Tina Bodine, a nurse navigator at Ohio State’s Neurological Institute. About 30% of in-hospital falls are estimated to be preventable.
The majority of fall prevention strategies centre on patient education, raising nurse awareness, or proactive actions like the installation of pressure sensors in beds and chairs. As most falls happen when patients attempt to get out of bed to use the toilet, bed and chair pressure monitors are fairly frequent in hospitals. Other studies have revealed that, although being widely used, bed and chair pressure sensors do not reduce falls in hospitals.
The high rate of false alerts, according to Bodine, “is a big issue with bed and chair pressure sensors since it may generate ‘alarm fatigue’ and contribute to delayed response.” Only 0.2% of the warnings generated by this system were false alarms, and no falls were reported. The median nurse response time was 24 seconds, according to our analysis of nurse response times, which ranged from 1 second to almost 10 minutes.
Researchers lacked historical reaction times for participating units as well as published nurse response times to bed and chair pressure sensors.
According to Moore, “our staff felt that response times were improved compared with the use of bed and chair alarms, among others, because alarm notifications included room numbers, targeted the three closest clinical staff members, and directly notified nurses rather than indirectly through a nurse station.”
Moore, T., et al. (2022) Fall Prevention With the Smart Socks System Reduces Hospital Fall Rates. Journal of Nursing Care Quality. doi.org/10.1097/NCQ.0000000000000653.