UTHSC Receives NIH Grant to Study Patient Fall Prevention

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The NIH has awarded the UTHSC an $800,000 grant to study the effect of alarm monitoring in reducing hospitalized patient falls.

The National Institutes of Health has awarded the University of Tennessee Health Science Center (UTHSC) a $800,000 grant to study the effect of alarm monitoring in reducing hospitalized patient falls. The study will be conducted under the supervision of Ronald Shorr, M.D., M.S. at Methodist University Hospital over a three-year period. Dr. Shorr is associate program director of medical education at Methodist Healthcare and UTHSC associate professor of preventive medicine.

“Methodist Healthcare has made significant investments to improve patient safety and reducing falls is among its highest priorities,” said Dr. Shorr. “Falls are a common, serious and growing threat to safety in hospitalized patients, but there is no solid research that shows whether alarms really made a difference.”

Research shows that more than one million falls among hospital patients occur annually, with 30% or more resulting in moderate to severe injuries such as hip fractures and head injuries. Alarm systems can prevent falls by alerting nurses when patients attempt to leave the bed or chair without assistance. They can also remind patients to seek assistance when attempting to move from bed, chair or commode.

An initial grant awarded to Dr. Shorr by the Methodist Healthcare Foundation served as pilot data for this project. The goals of the project are to determine if alarm monitoring reduces hospitalized patient falls, evaluate the effect of alarm monitoring in reducing the use of physical restraints, and determine if alarm monitoring decreases patient care costs.

During the study, 16 general medical-surgical nursing units at Methodist University Hospital will be randomized to receive the alarm-based intervention or utilize existing nursing care methods to minimize falls. Nursing units that use the alarms will receive BedEx Patient Occupancy Monitoring Systems to apply to all patients at high risk for falls.

An implementation team, consisting of a nurse-champion and a geriatrician, will conduct an initial in-service for nurses on intervention units and provide regular follow-up with nurses to address technical issues related to use of the alarms. In these sessions, problems with adaptation of alarms, such as nuisance calls and unidentified near misses will also be addressed. Fall information will be determined prospectively by a “fall evaluator,” a nurse who will provide continuous on-site coverage throughout the study. Based on our previous studies, fall evaluators typically respond within a few minutes of a patient fall and collect, in a standardized manner, patient (e.g., orientation and postural blood pressure) and environmental data and interview witnesses and floor nursing staff.

“Falls are such a problem for the frail and elderly. Anytime you have a fall, it may lead to a downward spiral,” said Linda Rosenblatt, R.N., B.S., clinical director of Methodist’s Skilled Nursing Facility. “We are very glad to be conducting this study at Methodist Healthcare, especially since the Joint Commission on Accreditation of Healthcare Organizations is putting more and more emphasis on falls prevention. Through this study, we’re hoping to find out whether we can produce better patient outcomes.”

Investigators participating in this project include:

Ron Shorr, MD (University of Tennessee Health Science Center and Methodist Healthcare): principal investigator will provide monitoring of the falls evaluation activities
Andy Bush (University of Tennessee Health Science Center)
Grant Somes (University of Tennessee Health Science Center)
Lorrain Mion (MetroHealth Medical Center in Cleveland, Ohio
Teresa Waters (University of Tennessee Health Science Center)
Steve Miller, MD (University of Tennessee Health Science Center and Methodist Healthcare)
Lori Kessler (Methodist Healthcare)
Linda Rosenblatt (Methodist Healthcare)

Henry Herrod, M.D., dean of the UTHSC College of Medicine, said, “The type of recognition represented by this grant reflects on the outstanding work of Dr. Shorr and his colleagues. These investigators are engaged in important studies that focus on how we can make healthcare safer, and it fits well with our commitment to instruct students on how to make patient care safe, timely, efficient, equitable and patient-centered.”

“This research project is yet another example of the strong affiliation between UT Health Science Center and Methodist Healthcare,” said Stephen Miller, M.D., senior vice president of research and education for Methodist Healthcare. “It is collaborations such as this that will enhance patient care and move both institutions forward.”