通过视频事件回顾降低痴呆症管理式医疗中的跌倒率：试点研究

Reduction in Fall Rate in Dementia Managed Care Through Video Incident Review: Pilot Study.

作者信息

Bayen Eleonore, Jacquemot Julien, Netscher George, Agrawal Pulkit, Tabb Noyce Lynn, Bayen Alexandre

机构信息

Pitie-Salpetriere Hospital - Assistance Publique Hôpitaux de Paris (APHP) & University Pierre et Marie Curie, Department of Neuro-Rehabilitation, Global Brain Health Institute, Memory and Aging Center, University of California, San Francisco, Paris, France.

SafelyYou Inc. at SkyDeck (Chief Technology Officer), Electrical Engineering and Computer Sciences, University of California, Berkeley, CA, United States.

出版信息

J Med Internet Res. 2017 Oct 17;19(10):e339. doi: 10.2196/jmir.8095.

DOI:10.2196/jmir.8095

PMID:29042342

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5663952/

Abstract

BACKGROUND

Falls of individuals with dementia are frequent, dangerous, and costly. Early detection and access to the history of a fall is crucial for efficient care and secondary prevention in cognitively impaired individuals. However, most falls remain unwitnessed events. Furthermore, understanding why and how a fall occurred is a challenge. Video capture and secure transmission of real-world falls thus stands as a promising assistive tool.

OBJECTIVE

The objective of this study was to analyze how continuous video monitoring and review of falls of individuals with dementia can support better quality of care.

METHODS

A pilot observational study (July-September 2016) was carried out in a Californian memory care facility. Falls were video-captured (24×7), thanks to 43 wall-mounted cameras (deployed in all common areas and in 10 out of 40 private bedrooms of consenting residents and families). Video review was provided to facility staff, thanks to a customized mobile device app. The outcome measures were the count of residents' falls happening in the video-covered areas, the acceptability of video recording, the analysis of video review, and video replay possibilities for care practice.

RESULTS

Over 3 months, 16 falls were video-captured. A drop in fall rate was observed in the last month of the study. Acceptability was good. Video review enabled screening for the severity of falls and fall-related injuries. Video replay enabled identifying cognitive-behavioral deficiencies and environmental circumstances contributing to the fall. This allowed for secondary prevention in high-risk multi-faller individuals and for updated facility care policies regarding a safer living environment for all residents.

CONCLUSIONS

Video monitoring offers high potential to support conventional care in memory care facilities.

摘要

背景

患有痴呆症的人跌倒频繁、危险且代价高昂。早期发现并了解跌倒史对于认知障碍患者的有效护理和二级预防至关重要。然而，大多数跌倒仍是无人目睹的事件。此外，了解跌倒发生的原因和方式是一项挑战。因此，对现实世界中的跌倒进行视频捕捉和安全传输是一种很有前景的辅助工具。

目的

本研究的目的是分析对痴呆症患者跌倒进行持续视频监测和审查如何能支持提高护理质量。

方法

2016年7月至9月在加利福尼亚州的一家记忆护理机构进行了一项试点观察性研究。通过43个壁挂式摄像头（部署在所有公共区域以及40间同意参与的居民和家属的私人卧室中的10间）对跌倒进行24×7视频捕捉。通过定制的移动设备应用程序向机构工作人员提供视频审查。结果指标包括视频覆盖区域内居民跌倒的次数、视频记录的可接受性、视频审查分析以及护理实践中的视频回放可能性。