Internal Medicine, Virginia Tech Carilion School of Medicine, Roanoke, Virginia, USA
Internal Medicine, Edward Via College of Osteopathic Medicine, Blacksburg, Virginia, USA.
BMJ Open Qual. 2024 Feb 20;13(1):e002569. doi: 10.1136/bmjoq-2023-002569.
A quality improvement study evaluated the effectiveness of implementing self-releasing chair alarm belts in an inpatient rehabilitation facility (IRF) for patients who had a stroke. The objective of this study is to assess the effectiveness of self-releasing chair alarms as a chair-level fall preventive tool in patients who had a stroke in the IRF setting.
A preintervention and postintervention quality improvement study was conducted in an IRF to address the high rate of falls in the stroke population. Falls from wheelchairs were identified as a significant concern, leading to the implementation of self-releasing safety belts (Posey HeadStart Notification Sensor Belts) with alarm systems as an intervention. In the preintervention phase (July 2021 to January 2022) falls from chairs while on standard fall precautions were recorded to establish a baseline. In the intervention phase, the self-releasing chair alarm belts were introduced along with standard fall precautions. The postintervention phase spanned from February 2022 to July 2022.
In the preintervention phase, 20 out of 86 stroke subjects experienced a total of 30 falls from chairs. However, in the postintervention phase, only one subject experienced a fall from a chair out of 104 stroke subjects. The mean percentage of subjects involved in falls decreased from 24±11.4% to 1±0.4% (p<0.00001), and the mean fall rate per 1000 patient days declined from 4.6±2 to 0.2±0.1 (p<0.0001).
The implementation of self-releasing chair alarm belts significantly reduced falls from chairs among patients who had a stroke in the IRF setting. These findings highlight the effectiveness of this intervention in improving patient safety and fall prevention in IRFs.
一项质量改进研究评估了在住院康复机构（IRF）为中风患者实施自释放椅警报带的有效性。本研究的目的是评估自释放椅警报作为中风患者在 IRF 环境中预防椅上跌倒的工具的有效性。
在 IRF 中进行了一项预干预和后干预的质量改进研究，以解决中风患者中高跌倒率的问题。轮椅跌倒被认为是一个重大问题，因此实施了带有警报系统的自释放安全带（Posey HeadStart 通知传感器带）作为干预措施。在预干预阶段（2021 年 7 月至 2022 年 1 月），记录了在使用标准防跌倒措施时从椅子上跌落的情况，以建立基线。在干预阶段，引入了自释放椅警报带，并同时采用了标准防跌倒措施。后干预阶段从 2022 年 2 月持续到 2022 年 7 月。
在预干预阶段，86 名中风患者中有 20 名总共发生了 30 次从椅子上跌落的情况。然而，在后干预阶段，104 名中风患者中只有 1 名从椅子上跌落。涉及跌倒的患者的平均百分比从 24±11.4%下降到 1±0.4%（p<0.00001），每 1000 名患者天的平均跌倒率从 4.6±2 下降到 0.2±0.1（p<0.0001）。
在 IRF 环境中为中风患者实施自释放椅警报带显著降低了椅子跌倒的发生率。这些发现强调了该干预措施在提高 IRF 患者安全性和预防跌倒方面的有效性。
