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REFINE (REducing Falls in In-patieNt Elderly) using bed and bedside chair pressure sensors linked to radio-pagers in acute hospital care: a randomised controlled trial

Sahota, Opinder; Drummond, Avril; Kendrick, Denise; Grainge, Matthew J.; Vass, Catherine; Sach, Tracey; Gladman, John R.F.; Avis, Mark

Authors

Opinder Sahota opinder.sahota@nuh.nhs.uk

Avril Drummond Avril.Drummond@nottingham.ac.uk

Denise Kendrick

Matthew J. Grainge

Catherine Vass

Tracey Sach

John R.F. Gladman john.gladman@nottingham.ac.uk

Mark Avis



Abstract

Background: falls in hospitals are a major problem and contribute to substantial healthcare burden. Advances in sensor technology afford innovative approaches to reducing falls in acute hospital care. However, whether these are clinically effective and cost effective in the UK setting has not been evaluated.

Methods: pragmatic, parallel-arm, individual randomised controlled trial of bed and bedside chair pressure sensors using radio-pagers (intervention group) compared with standard care (control group) in elderly patients admitted to acute, general medical wards, in a large UK teaching hospital. Primary outcome measure number of in-patient bedside falls per 1,000 bed days.

Results: 1,839 participants were randomised (918 to the intervention group and 921 to the control group). There were 85 bedside falls (65 fallers) in the intervention group, falls rate 8.71 per 1,000 bed days compared with 83 bedside falls (64 fallers) in the control group, falls rate 9.84 per 1,000 bed days (adjusted incidence rate ratio, 0.90; 95% confidence interval [CI], 0.66–1.22; P = 0.51). There was no significant difference between the two groups with respect to time to first bedside fall (adjusted hazard ratio (HR), 0.95; 95% CI: 0.67–1.34; P= 0.12). The mean cost per patient in the intervention group was £7199 compared with £6400 in the control group, mean difference in QALYs per patient, 0.0001 (95% CI: −0.0006–0.0004, P= 0.67).

Conclusions: bed and bedside chair pressure sensors as a single intervention strategy do not reduce in-patient bedside falls, time to first bedside fall and are not cost-effective in elderly patients in acute, general medical wards in the UK.

Journal Article Type Article
Publication Date 2014-03
Journal Age and Ageing
Electronic ISSN 1468-2834
Publisher Oxford University Press
Peer Reviewed Peer Reviewed
Volume 43
Issue 2
Pages 247-253
APA6 Citation Sahota, O., Drummond, A., Kendrick, D., Grainge, M. J., Vass, C., Sach, T., …Avis, M. (2014). REFINE (REducing Falls in In-patieNt Elderly) using bed and bedside chair pressure sensors linked to radio-pagers in acute hospital care: a randomised controlled trial. Age and Ageing, 43(2), 247-253. https://doi.org/10.1093/ageing/aft155
DOI https://doi.org/10.1093/ageing/aft155
Publisher URL http://ageing.oxfordjournals.org/content/43/2/247.full
Copyright Statement Copyright information regarding this work can be found at the following address: http://creativecommons.org/licenses/by/4.0
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