PICO Question PICO question: In elderly patients, is patient monitoring using wearable devices compared to normal monitoring effective in reducing the number of patients falls?

Research Studies Analysis

Technology advancements infiltration into the healthcare sector has significantly improved healthcare outcomes. Wearable technology advancements are used in various sectors and majorly in the intensive care unit settings to closely monitor high-risk patients with major respiratory, cardiovascular, and neurological compromises. They aid in close patient monitoring. The significance of wearable devices in patient monitoring is of interest in preventing patients’ falls. Patient falls among geriatrics are a significant healthcare issue, and interventions to ensure adequate monitoring and reduced falls are essential.

Patient falls are unplanned often sudden descent to the floor and encompass incidences with or without injury. They are common, devastating, and avoidable complications during patient care, especially among elderly patients. The Agency for Healthcare Quality and Research estimates that between 700000-1000000 hospitalized patients fall each year (LeLaurin & Shorr, 2019). Patients fall due to various reasons. Poor vision, especially among the elderly, is a major cause of falls. Some medications cause side effects such as dizziness and body weaknesses and result in patient falls. As LeLaurin and Shorr (2019) further observe, patients are often weakened by their underlying conditions and fall when attempting to meet their needs, such as moving out of bed without assistance.

In addition, environmental hazards such as slippery floors and poor infrastructures such as lack of side rails, poor floor material, and lack of bedside rails significantly contribute to patient falls (LeLaurin & Shorr, 2019). Patient falls vary with intensity. Some falls result in no harm; mild ones result in twisting, bruising, and cuts, while major falls result in fractures, major internal organ damage, and sometimes, patient death. Patient falls result in prolonged hospital stays and increased healthcare costs. Patient falls lead to about $50billion in healthcare costs every year and other law-suit-related costs (Green et al., 2019). Patient falls are thus a major issue in nursing practice. Patient monitoring and assistance with activity performance is a nursing intervention. An intervention to enhance patient monitoring and prevent patient falls is thus essential.

Research Findings

Pang et al. (2019) carried out a systematic review that provides a high level of evidence (Level I) on wearable devices to prevent falls among patients of all ages. The study utilized credible articles from recognized databases such as CINAHL and MEDLINE. Analysis of the nine articles showed that wearable devices improve detection and correction of the patient near falls by a huge percentage (above 30%). These devices include gyroscopes, and their main location is the patients’ waists. The devices have high reliability and validity measures and are thus integral in preventing falls among elderly patients. The study also recommends the inclusion of other factors such as differentiation between actual and near falls and a provision for naturally occurring near falls, not necessarily associated with the patient’s situation. However, the study includes patients of all ages, and the main interest is the elderly population. In addition, the study is a systematic review, but it only utilizes nine research studies; hence usability and generalizability of the information on all patients are difficult.

Greene et al. (2019) conducted an observational study to determine the impact and importance of using wearable devices and digital fall risks evaluation tools to minimize falls among geriatric patients. It provides a strong level of evidence (level III). According to Greene et al. (2019), “Current methods for assessing falls risk can be subjective, inaccurate, have low inter-rater reliability, and do not address factors contributing to falls (poor balance, gait speed, transfers, turning)” (p2). The study utilized data from the participants collected used a digital falls risk assessment protocol. Data used was from questionnaires regarding the risk for falls and data captured by the wearable technology devices. Using the digital falls risk assessment tool can help reduce outpatient and emergency department utilization secondary to falls in the elderly patients, as evidenced by the results (45% reduction in patient falls) (Greene et al., 2019). The study supports wearable devices such as gait sensors alongside digital evaluation tools to detect and prevent falls among elderly patients. However, the study limitation si the few participants (small sample size), which minimizes the validity of the information.

Hussain et al. (2018) evaluated the importance of utilizing wearable sensors in geriatric pat