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Development and pilot study of a bed-exit alarm based on a body-worn accelerometer

Entwicklung und Pilotstudie eines Bettenausstiegsalarms mittels körperbezogener Beschleunigungssensoren

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Abstract

Background

Falls are a major problem in hospitals and nursing homes. The consequences of falls can be severe, both for the individual and for the caring institution.

Objective

The aim of the work presented here is to reduce the number of falls on a geriatric ward by monitoring patients more closely. To achieve this goal, a bed-exit alarm that reliably detects an attempt to get up has been constructed.

Materials and methods

A requirements analysis revealed the nurses’ and physicians’ needs and preferences. Based on the gathered information, an incremental design process generated different prototypes. These were tested for the reliability of their ability to detect attempts to get up in both laboratory settings and with geriatric patients. Based on the result of these tests, a scalable technical solution has been developed and proven its reliability in a 1-year, randomized controlled pilot clinical trial on a geriatric ward.

Results

The developed system is unobtrusive and easy to deploy. It has been tested in laboratory settings, usability tests and a 1-year randomized clinical trial with 98 patients. This paper focuses on the technical development of the system. We present different prototypes, the experiments and the pilot study used to evaluate their performance. Last but not least, we discuss the lessons learned so far.

Conclusion

The developed bed-exit alarm is able to reliably detect patients’ attempts to get up. The results of the clinical trial show that the system is able to reduce the number of falls on a geriatric ward. Next steps are the design of a specialized sensor node that is easier to use and can be applied on an even larger scale due to its reduced cost. A multicenter trial with a larger number of patients is required to confirm the results of this pilot study.

Zusammenfassung

Hintergrund

Stürze in Krankenhäusern und Pflegeheimen stellen ein großes Problem mit teils schwerwiegenden Folgen, sowohl für das Individuum als auch für die Einrichtung, dar.

Zielsetzung

Ziel der vorliegenden Arbeit ist die Reduktion der Anzahl von Stürzen auf Geriatriestationen durch eine engmaschige Überwachung. Für dieses Ziel wurde ein Bettenaustiegsalarm entwickelt, der zuverlässig Aufstehversuche erkennt.

Methode

Eine Anforderungsanalyse, die mit Pflegenden und Medizinern durchgeführt wurde, ergab wesentliche Anforderungen und Wünsche. Ein inkrementeller Designprozess generierte Prototypen, die unter Laborbedingungen und mit einigen geriatrischen Patienten auf Zuverlässigkeit der Erkennung getestet und verfeinert wurden. Ergebnis dieses Prozesses ist eine skalierbare technische Lösung, die ihre Zuverlässigkeit in einer einjährigen Pilotstudie auf einer Geriatriestation bewies.

Ergebnisse

Das System ist unaufdringlich, leicht einzusetzen und wurde unter Laborbedingungen, in kurzen klinischen Tests und in einer einjährigen klinischen Studie mit 98 Patienten getestet. Diese Arbeit beschreibt v. a. die technische Entwicklung des Systems. Sie stellt die verschiedenen Prototypen, die Experimente und die Pilotstudie vor und beschreibt die gewonnenen Erkenntnisse.

Schlussfolgerungen

Das entwickelte Bettenausstiegsalarmsystem erkennt sehr zuverlässig Versuche das Bett zu verlassen. Die klinische Studie deutet darauf hin, dass durch den Einsatz des Systems die Sturzrate auf der Geriatriestation gesenkt wurde. Die nächsten Schritte sind die Entwicklung eines speziellen Sensorkontens, der aufgrund der geringeren Stückkosten besser skaliert und einfacher anzuwenden ist. Eine multizentrische Studie mit größeren Patientenzahlen soll die Ergebnisse der Pilotstudie festigen.

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Acknowledgments

The authors would like to thank the students Konstantyn Kucher, Gedo Jansen and Christopher Gerloff who did most of the technical prototyping work and provided technical support during the clinical study. We offer particular thanks to the team of the GMED 2 geriatric ward at the Braunschweig Clinical Center who enabled this research through their invaluable support.

Compliance with ethical guidelines

Conflict of interest. K.-H. Wolf, K. Hetzer, H. Meyer zu Schwabedissen, B. Wiese and M. Marschollek state that there are no conflicts of interest.

All studies on humans described in the present manuscript were carried out with the approval of the responsible ethics committee and in accordance with national law and the Helsinki Declaration of 1975 (in its current, revised form). Informed consent was obtained from all patients included in studies.

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Authors and Affiliations

  1. Peter L. Reichertz Institute for Medical Informatics University of Braunschweig – Institute of Technology and Hannover Medical School, Mühlenpfordtstr. 23, 38106, Braunschweig, Germany

    K.-H. Wolf

  2. Medizinische Klinik IV; Geriatrie; Rheumatologie Klinikum Braunschweig, Braunschweig, Germany

    K. Hetzer & H.M. zu Schwabedissen

  3. Institute for Biometry, Hannover Medical School, Hannover, Germany

    B. Wiese

  4. Peter L. Reichertz Institute for Medical Informatics University of Braunschweig – Institute of Technology and Hannover Medical School, Hannover, Germany

    M. Marschollek

Authors
  1. K.-H. Wolf
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  2. K. Hetzer
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  3. H.M. zu Schwabedissen
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  4. B. Wiese
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  5. M. Marschollek
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Corresponding author

Correspondence to K.-H. Wolf.

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Wolf, KH., Hetzer, K., zu Schwabedissen, H. et al. Development and pilot study of a bed-exit alarm based on a body-worn accelerometer. Z Gerontol Geriat 46, 727–733 (2013). https://doi.org/10.1007/s00391-013-0560-2

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  • DOI: https://doi.org/10.1007/s00391-013-0560-2

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