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Bed Fall Prevention

Sara Hook and Amber Strickland

Background

Our Design

Evaluation

Assessment

Bracelet

The colored bracelet has a gyroscope sensor implanted in it that detects when the patient is attempting to leave the bed. This movement will trigger the nurse’s pager to vibrate, alerting the nursing home staff that a patient is attempting to leave the bed. The pager will display the patient’s name, room number and assigned color.

When patients are admitted into the nursing home they will undergo a falls risk assessment. Based on the numeric score they received on the assessment they will be assigned a color (yellow for slight risk, red for high risk) and this color will be displayed on a wristband that the patients will wear.

One third of adults over the age of 65 experience a fall each year. Seniors are more prone to fall in nursing home settings. For every 100 beds in a nursing home, 100 to 200 falls are reported annually. Nursing home residents commonly fall when making an effort to exit the bed. According to our shadowing experience with James Njui at Judson Bruening Health Center, residents primarily exit the bed in attempt to go to the restroom (personal communication, October 21, 2014). Residents who fall often suffer from injuries that cause impairment, declines in physical function, and/or reduced quality of life. Approximately 1,800 nursing home residents die as a result of fall related injuries per year. Residents that experience falls spend over $160 million during their lifetime on healthcare. Health care providers may be considered liable for patient falls costing them their reputation. Falls directly cost the US health care system approximately $30 billion annually.

Goal

In order to evaluate the competency of the device, it must adhere to the user and technical specifications that were developed before the brainstorming process began. The first priority of the user specifications is that the device cannot be classified as a restraint. The design created is not a restraint because it does not prohibit the patient movement, and the resident is capable of leaving the bed at their will. The second requirement that the design complies with is that the patients will not fall while attempting to exit the bed. A pre-recorded voice, usually that of a family member’s will remind the patients to wait for assistance to exit the bed. This will most likely keep the patients from venturing out of the bed by themselves. The device must not impede the clinician’s care for the resident. The design involves the patient wearing a bracelet, which will not prevent the nursing home staff from providing care to the resident. The staff will have to move the commode in the morning, but that requires minimal effort and does not greatly obstruct the clinician’s ability to support the patient. The device is adaptable to different bed sizes since nothing is attached to the bed. Over all, the design will be easy for the nursing home staff to use. The bracelet will be comfortable for the patient to wear and it will not inflict more harm upon the resident. The design met the user specifications created prior to the brainstorming process.

To collaborate with biomedical engineering students to create a device that prevents geriatric residents in nursing homes from falling when attempting to leave the bed.

The Voice

The Commode

The majority of falls occur due to incontinence. To address this issue, we will create a commode with assistive guide rails, emulating a walker, to help patients safely use the restroom.

When the gyroscope detects a patient’s movement it will activate a pre recorded voice, preferably a relative, reminding the patient to remain in bed and wait for the nursing home staff to assist them. The purpose of this is to delay patients from leaving their bed without assistance.

Graphs

Graph

Injuries from falls were the most common conditions accounting for potentially preventable Emergency Room visits by nursing home residents

Total lifetime medical costs of Unintentional Fatal Fall-Related Injuries in People 65 Years and Older By Sex and Age, United States, 2005

Design Process

Observations

As nursing students, we were able to provide clinical background knowledge to assist the biomedical engineering students design an effective device to prevent falls in nursing home residents. We participated in creating the user and technical specifications, the brainstorming process, took part in the concept selection matrix, and assisted them with researching and observations at a local nursing home. Our experiences and research assisted in shaping the final design.

To receive current information on bed falls in nursing homes, we decided to shadow at Judson, a nursing home near Case Western Reserve University. During our visit at Judson, we spoke with James Njui an LPN, who works specifically with the staff to prevent the residents from falling. In order to prevent falls, Judson attempts to anticipate the needs of its residents. James instituted a toileting program for each of the residents. At this nursing home, 75% of the falls are a result of patients attempting to use the restroom by themselves. Enforcing a toileting program ensures that the patients’ bodily needs are meet and decreases the number of falls. The majority of Judson’s falls prevention interventions are actually fall reaction interventions. They place mattresses on the floors to cushion patients’ landings, they lower beds close to the ground to prevent injury, and they have a sink mattress, which slopes a bit on the sides in order to hinder residents from getting out of bed. James stressed that nursing homes cannot use restraints to prevent patients from falling. He also discussed his frustration with the inefficient call bell system that is implemented at Judson. James emphasized that if the alarm system could be more efficient and incontinence problem addressed there would be a significant decrease in falls. Using this information, we collaborated with the BME students to create our final design.

Conclusion

References

Collaborating with the biomedical engineering students was an enlightening experience for us. We discovered the importance of inter collaboration between nurses and engineers in order to create products that address the needs of patients and clinicians. Our clinical experiences and research greatly influenced the final design of the bed fall prevention device. The next stage of the project is the construction phase. The biomedical engineering students will begin to implement and build our final design. Overall, this was a wonderful educational experience for us.

Caffrey, C. (2010, April). NCHS data brief. Retrieved from http://www.cdc.gov/nchs/data/databriefs/db33.htm

Cost of fall injuries in older persons in the United States, 2005. (2005). Retrieved from

http://www.cdc.gov/homeandrecreationalsafety/Falls/data/cost-estimates.html

Falls in nursing homes. (n.d.-a). Retrieved from http://www.cdc.gov/homeandrecreationalsafety/falls/nursing.html

Falls in nursing homes. (n.d.-b). Retrieved from

http://www.nursinghomeabusecenter.org/resources/Falls-and-Nursing-Home- Abuse.html

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