Falls, fractures and trauma 4 REFINE-REDUCING FALLS IN IN-PATIENT ELDERLY USING BED AND CHAIR PRESSURE SENSORS IN ACUTE HOSPITAL CARE: A RANDOMISED CONTROLLED TRIAL

Introduction: Advances in sensor technology afford innovative approaches to reducing falls in acute hospital care, however its clinical and cost-effectiveness has not been evaluated in a RCT. Method: Pragmatic, parallel-arm, randomised controlled trial of bed and bedside chair pressure sensors (intervention group) compared to standard care (control group) to reduce inpatient falls in high risk elderly patients admitted to acute, general medical wards, in a large UK teaching hospital. The primary outcome measure was the number of in-patient bedside falls per 1,000 bed days. Results: 1,839 participants were randomized (918 to the intervention group and 921 to the control group). There were 85 bedside falls (65 fallers) in the intervention group, with a falls rate of 8.71 per 1,000 bed days compared with 83 falls (64 fallers) in the control group, with a falls rate of 9.84 per 1,000 bed days (adjusted incidence rate ratio, 0.90; 95% confidence interval [CI], 0.66 to 1.22; p = 0.5). There was no significant difference between the two groups with respect to time to first fall (adjusted hazard ratio [HR], 0.95; 95% CI, 0.67 to 1.34; p = 0.12). The mean cost per patient in the intervention group was £7199 compared to £6400 in the control group, mean difference in QALYs per patient, 0.0001, not significant, (95% CI, −0.0006 to 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 fall and are not cost effective in high risk elderly patients in acute, general medical wards.