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Effectiveness of an Ambient Intelligent Geriatric Management system (AmbIGeM) to prevent falls in older people in hospitals: protocol for the AmbIGeM stepped wedge pragmatic trial
  1. Renuka Visvanathan1,
  2. Damith C Ranasinghe2,
  3. Anne Wilson3,4,
  4. Kylie Lange5,
  5. Joanne Dollard3,
  6. Eileen Boyle6,
  7. Jonathan Karnon7,
  8. Erfan Raygan2,
  9. Sean Maher8,
  10. Kate Ingram8,
  11. Shibu Pazhvoor1,
  12. Stephen Hoskins1,
  13. Keith Hill6
  1. 1Aged & Extended Care Services, The Queen Elizabeth Hospital, Adelaide, South Australia, Australia
  2. 2School of Computer Science, University of Adelaide, Adelaide, South Australia, Australia
  3. 3Adelaide Geriatrics Training and Research with Aged Care (GTRAC) Centre, Adelaide Medical School, University of Adelaide, Adelaide, South Australia, Australia
  4. 4School of Medicine, Flinders University of South Australia, Adelaide, South Australia, Australia
  5. 5Adelaide Medical School, University of Adelaide, Adelaide, South Australia, Australia
  6. 6School of Physiotherapy and Exercise Science, Curtin University, Perth, Western Australia, Australia
  7. 7School of Public Health, University of Adelaide, Adelaide, South Australia, Australia
  8. 8Department of Rehabilitation and Aged Care, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia
  1. Correspondence to Prof Renuka Visvanathan, Aged & Extended Care Services, The Queen Elizabeth Hospital, Adelaide, South Australia, Australia; renuka.visvanathan{at}adelaide.edu.au

Abstract

Background Although current best practice recommendations contribute to falls prevention in hospital, falls and injury rates remain high. There is a need to explore new interventions to reduce falls rates, especially in geriatric and general medical wards where older patients and those with cognitive impairment are managed.

Design and methods A three-cluster stepped wedge pragmatic trial, with an embedded qualitative process, of the Ambient Intelligent Geriatric Management (AmbIGeM) system (wearable sensor device to alert staff of patients undertaking at-risk activities), for preventing falls in older patients compared with standard care. The trial will occur on three acute/subacute wards in two hospitals in Adelaide and Perth, Australia.

Participants Patients aged >65 years admitted to study wards. A waiver (Perth) and opt-out of consent (Adelaide) was obtained for this study. Patients requiring palliative care will be excluded.

Outcomes The primary outcome is falls rate; secondary outcome measures are: (1) proportion of participants falling; (2) rate of injurious inpatient falls/1000 participant bed-days; (3) acceptability and safety of the interventions from patients and clinical staff perspectives; and (4) hospital costs, mortality and use of residential care to 3 months postdischarge.

Discussion This study investigates a novel technological approach to preventing falls in hospitalised older people. We hypothesise that the AmbIGeM intervention will reduce falls and injury rates, with an economic benefit attributable to the intervention. If successful, the AmbIGeM system will be a useful addition to falls prevention in hospital wards with high proportions of older people and people with cognitive impairment.

Trial registration number Australian and New Zealand Clinical Trial Registry: ACTRN 12617000981325; Pre-results.

  • Older People
  • Hospital Care
  • Fall

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Footnotes

  • Contributors RV, DCR, KH, AW, KL and JK provided substantial contribution to the conception and design of the work and obtaining funding, drafting and revising the work and final approval of the version to be published. JD, EB, ER, SM, KI, SP and SH have provided substantial contribution to the refinement of the design of the work, drafting and revising the work and final approval of the version to be published. All authors agree to be accountable for all aspects of the work.

  • Funding This study was funded by a project grant (1082197) from the National Health and Medical Research Council of Australia.

  • Competing interests None declared.

  • Patient consent Waiver of consent received for Western Australia and opt-out consent received for South Australia.

  • Ethics approval TQEH/Lyell McEwin Hospital (LMH)/Modbury Hospital (MH) and SCGH HREC.

  • Provenance and peer review Not commissioned; internally peer reviewed.

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