Rehabilitation, Ageing and Independent living (RAIL) Research Centre, School of Primary and Allied Health Care, Monash University, Level 3, Building G, Peninsula Campus, McMahons Road, Frankston, Victoria 3199, Australia.
Monash Health, Monash Medical Centre, 246 Clayton Road, Clayton, Victoria 3168, Australia; School of Nursing and Midwifery, Centre for Quality and Patient Safety Research, Institute for Health Transformation, Deakin University, Geelong, VIC 3220, Australia.
Int J Nurs Stud. 2021 May;117:103769. doi: 10.1016/j.ijnurstu.2020.103769. Epub 2020 Sep 2.
Mobilisation alarms are a falls prevention strategy used in hospitals to alert staff when an at risk patient is attempting to mobilise. Mobilisation alarms have an estimated annual cost of $AUD58MIL in Australia. There is growing evidence from randomised controlled trials indicating mobilisation alarms are unlikely to prevent falls.
The primary aim of this study was to describe the rate of mobilisation alarm false triggers and staff response time across different health services. The secondary aim was to compare pre to post mobilisation alarm utilisation following the introduction of policy to reduce or eliminate mobilisation alarms.
This descriptive and comparative study was conducted through Monash Partners Falls Alliance across six health services in Melbourne, Australia. This study described true and false alarm triggers and trigger response times across three health services and usual care mobilisation alarm utilisation across six health services; and then compared alarm utilisation across two health services following the introduction of policy to reduce (<2.5%) or eliminate (0.0%) mobilisation alarms in the acute and rehabilitation settings.
The most frequent observation was a false alarm (n = 74, 52%), followed by a true alarm (n = 67, 47%) and no alarm (n = 3, 2%). Time to respond to the true and false alarms was an average of 37 seconds (SD 92) and this included 61 occasions of 0 seconds as a member of staff was present when the alarm triggered. If the 61 occasions of staff being present when the alarm triggered were removed, the average time to respond was 65 seconds (SD114). Usual care mobilisation alarm utilisation in acute was 7% (n = 171/2,338) and in rehabilitation was 11% (n = 286/2,623). Introducing policy for reduced and eliminated mobilisation alarm conditions was successful with a reduced utilisation rate of 1.8% (n = 11/609) and an eliminated utilisation rate of 0.0% (n = 0/521).
Half of mobilisation alarm triggers are false and when alarms trigger without staff present, staff take about a minute to respond. While usual care has one in fourteen patients in acute and one in nine patients in rehabilitation using a mobilisation alarm, it is possible to introduce policy which will change practice to reduce or eliminate the use of mobilisation alarms, providing evidence of feasibility for future disinvestment effectiveness studies that it is feasible to disinvest in the alarms.
动员警报是一种预防跌倒的策略，用于在医院提醒工作人员有跌倒风险的患者试图活动时。动员警报在澳大利亚的估计年度成本为 5.8 亿澳元。越来越多的随机对照试验证据表明，动员警报不太可能预防跌倒。
本研究的主要目的是描述不同医疗服务机构的动员警报误触发率和工作人员响应时间。次要目的是比较引入减少或消除动员警报的政策前后的动员警报使用情况。
这项描述性和比较性研究是通过莫纳什合作伙伴跌倒联盟在澳大利亚墨尔本的六个医疗服务机构进行的。该研究描述了三个医疗服务机构的真实和虚假警报触发以及触发响应时间，以及六个医疗服务机构的常规护理动员警报使用情况；然后比较了在引入政策以减少（<2.5%）或消除（0.0%）急性和康复环境中的动员警报后，两个医疗服务机构的警报使用情况。
最常见的观察结果是误报（n=74，52%），其次是真报（n=67，47%）和无报（n=3，2%）。响应真实和虚假警报的平均时间为 37 秒（SD 92），其中包括 61 次 0 秒，因为当警报触发时，有一名工作人员在场。如果将 61 次工作人员在警报触发时在场的情况排除在外，平均响应时间为 65 秒（SD114）。急性护理中的常规护理动员警报使用率为 7%（n=171/2338），康复护理中的使用率为 11%（n=286/2623）。引入减少和消除动员警报条件的政策是成功的，使用率降低到 1.8%（n=11/609），消除使用率为 0.0%（n=0/521）。
动员警报触发中有一半是误报，当警报没有工作人员在场触发时，工作人员需要大约一分钟的时间来响应。虽然常规护理中有 14%的急性患者和 9%的康复患者使用动员警报，但引入政策改变实践以减少或消除动员警报的使用是可能的，为未来的投资有效性研究提供了证据，表明投资于警报是可行的。
