Assessment of a wearable fall prevention system at a veterans health administration hospital

Abstract

Objective: In-hospital falls are a significant cause of morbidity and mortality. The Veterans Health Administration (VHA) has designated fall prevention as a major focus area. The objective of this report is to assess the performance of a new sensor-enabled wearable system to prevent patient falls.

Methods: An integrated sensor-enabled wearable SmartSock system was utilized to prevent falls at the acute care wards of a large VA hospital. Individual patients were only provided the SmartSocks when they were determined to be at high risk of falling. All fall count rates, with and without using the SmartSock, were evaluated and compared for individual patients. SmartSock sensor and electronic health record data were combined to assess the system's performance from February 10, 2021, through October 31, 2021.

Results: There were 20.7 falls per 1000 ward days of care (WDOC) for those not using the SmartSocks compared to 9.2 falls per 1000 WDOC for patients using the SmartSocks. This represents a reduction of falls by more than half. These findings are further confirmed with a negative binomial regression model, which showed the use of the SmartSock had a statistically significant effect on the rate of falls (p = 0.03) when length of stay was held constant and demonstrated the odds of fall incident rate of 0.48 (95% CI, 0.24-0.92), that is less than half compared to when patients were not wearing the SmartSock.

Conclusion: The use of a sensor-enabled wearable SmartSock fall prevention system resulted in a clinically meaningful and statistically significant decrease in falls in the acute care setting.

Keywords: Digital health; e-health; fall prevention; health technology; informatics; innovation; patient safety; quality improvement; remote patient monitoring; sensors; wearable.

Figure 1.

The PuP ® SmartSock is viewed from below (a) and from the side (b). From below, the three integrated pressure sensors are identified as black squares, the raised nonskid treads are tan, and the Inertial Measurement Unit is attached to the SmartSock above the lateral aspect of the ankle (a).

Figure 2.

Smart badge with screen display identifying room number location of the alert.

Figure 3.

Plot of the negative binomial (NB) regression model with fitted lines of the association between the ward hours of care and expected fall count, when wearing the SmartSock (teal) and not wearing the SmartSock (red). The accompanying shaded area represents the confidence intervals for each group.