Category: Brain Injury; Clinical Practice (assessment, diagnosis, treatment, knowledge translation/EBP, implementation science, program development); Quality Improvement and Implementation Science
Reduce the number of patient falls by using a patient monitoring system.
Design : Retrospective analysis for performance improvement.
Acute inpatient rehabilitation 30 bed brain injury unit.
Participants (or Animals, Specimens, Cadavers) :
Adults with moderate to severe brain injury admitted to the brain injury unit.
Install CareView room monitoring cameras which transmits live images to a centralized monitor at the nursing station. The patients are monitored constantly using predictive fall technology by staff who communicates imminent fall risk to unit staff.
Main Outcome Measure(s) :
Number of patient falls before and after room monitoring cameras were installed.
CareView1 monitoring was installed in April 2018. Prior to the installation of CareView, there were 30 falls on the unit for 331 discharged patients between April to December of 2017 equaling 9.06%. After CareView monitoring system was installed, there were 24 falls on the unit for 379 discharged patients between April to December of 2018, equaling 6.3%. In 2018, 10 of the falls occurred in a location that was not being monitored, i.e. bathrooms or hallways. In 2017, 10 of the falls occurred in a location that would not have monitoring if monitoring had been in place. Two of the injuries in 2017 were falls that resulted in neurological injuries. None of the falls in 2018 involved serious injuries.
In patients with brain injury, disinhibition and lack of safety awareness are common symptoms that contribute to falls2. Consistent monitoring is imperative to fall prevention. The CareView system helped to reduce the falls that occurred and the severity of the injury that resulted from falls on the unit. The monitoring also enabled the patients to stay in their rooms with less noise and stimulation while still monitoring their safety.
Rachel Feld-Glazman– Brain Injury Program Director, The Burke Rehabilitation Hospital, White Plains, New York
Erika Trovato– Co-Director, Inpatient Brain Injury Program, Burke Rehabilitation Hospital, White Plains, New York
Ashley Kakkanatt– Resident Physician, Montefiore Medical Center, Bronx, New York