Falls and Nursing Workload in Hospitalized Older Adults With Delirium: A Controlled Trial of 3D-Radar-Based Bed-Exit Monitoring Versus Contact Mat.

BACKGROUND

Reported in-hospital fall rates largely rely on subjective incident reporting, and objective verification is rarely used. Evidence on the effectiveness of bed-exit monitoring systems in patients with delirium is limited, and prospective data on digital contactless systems that do not rely on video-based monitoring are lacking.

METHODS

This prospective, monocentric, non-randomized controlled study was conducted on a specialized delirium care unit. Analogue bed-exit monitoring using a contact mat (CareMat) in front of the bed was compared with a digital contactless 3D-radar bed-exit monitoring system (QUMEA), which does not generate or record video data. Patients aged ≥ 65 years with delirium were allocated by room availability to analogue or digital bed-exit surveillance. Bed-exit-related falls, daily bed-exit warnings and nurse presence time were analyzed. Falls were identified using institutional records, electronic health records and system logs. For research purposes only, event-triggered thermal camera recordings were used for objective fall verification.

RESULTS

In 119 patients contributing 1799 patient days, bed-exit-related fall rates were 22.6 per 1000 patient days with CareMat and 11.5 with QUMEA adjusted OR, 3.76 (95% CI, 1.25-11.27). The analogue CareMat device generated more bed-exit warnings adjusted OR, 1.89 (95% CI, 1.41-2.53) and longer nurse presence times adjusted OR, 1.60 (95% CI, 1.21-2.11).

CONCLUSIONS

Under conditions of objective fall verification independent of the bed-exit monitoring systems, digital contactless 3D-radar bed-exit monitoring was associated with lower bed-exit-related fall rates and reduced nursing workload compared with an analogue contact mat.