Skip to content
  • About
  • Contact
  • Contribute
  • Book
  • Careers
  • Podcast
  • Recommended
  • Speaking
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
    • All
    • Physician
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • Video
    • About
    • Contact
    • Contribute
    • Book
    • Careers
    • Podcast
    • Recommended
    • Speaking

Bed alarms don’t work and won’t reduce patient falls

Ken Covinsky, MD
Conditions
January 14, 2013
637 Shares
Share
Tweet
Share

Many older patients fall in the hospital and these falls often lead to injury.  Hospitals are under a lot of pressure to reduce falls.   Generally, these falls happen when patients transfer such as when an older person tries to get out of bed or get up from a chair.   While hospitalized, many patients are weak, dizzy, or confused, and they can be at risk of falling when ambulating without assistance.

To reduce this risk, bed alarms have become ubiquitous at hospitals throughout the US.  When a patient is deemed to be at high risk of falling, weight sensitive pads are applied to the bed, chair, or commode.   When a patient tries to get up, an alarm sounds in the room and at the nursing station.  The alarm reminds the patient to wait for assistance, and alerts nursing staff to assist the patient.

Remarkably, these alarms have become widely used with virtually no evidence that they actually reduce falls, let alone any studies that examine the adverse consequences of restricting mobility.  I am not aware of any studies that ask patients how they feel about being attached to these devices. In general, hospitalized older patients are not even asked permission to apply these devices.

This context makes a study by Geriatrician Ron Shorr at the University of Florida particularly remarkable.  In a well done study, Shorr provides compelling evidence that these bed alarms fail miserably at their core purpose of preventing falls in high risk hospitalized patients.

To test the usefulness of bed alarms, they did the following.  They took 16 medical surgical units at a Memphis teaching hospital and randomly assigned 8 units to a bed alarm intervention and 8 units to usual care.  On the intervention unit, the staff received extensive training on the use of the bed alarms and was strongly encouraged to use the alarms on patients felt to be at high risk of falling.  Shorr and colleagues compared the rate of falling and fall injury before and after the bed alarm intervention was introduced on both the intervention and the control units.

The findings were as follows:

  • On the bed alarm units, there were 5.76 falls per 1000 patient days. About 1/4 resulted in injury
  • On the usual care unit, there were 4.56 falls per 1000 patient days.  About 1/4 resulted in injury
  • The trend towards higher fall rates on the intervention units was not statistically significant, so the study does not show that bed alarms lead to more falls.  But this trend almost certainly rules out any meaningful chance that this bed alarm system, as implemented in this study, can reduce the risk of falls.

This study raises serious questions about the growing use of bed alarms in US hospitals.  As the authors note, these systems are not cheap.

Maybe we need to rethink hospital fall prevention, and focus on more human and less technical solutions.  Bed alarms have the potential to be activity restricting.  This activity restriction can actually increase the risk of hospital acquired disabilities that are very common in hospitalized elders.

Frail older patients need to be encouraged to get out of bed and ambulate.   Solutions aimed at getting high risk patients the assistance they need when they need it are likely to be more effective than bed alarms.  Also, we need to learn how to make environmental modifications in our hospitals that make it safer when patients actually do fall so that these falls are less likely to cause injury.

So, add bed alarms to the long list of medical interventions that have been widely used despite no evidence that they actually work.

Ken Covinsky is Professor of Medicine, University of California, San Francisco who blogs at GeriPal.

Prev

Is it justifiable to judge a paper by its author or funding source?

January 13, 2013 Kevin 4
…
Next

Trust but verify: Medicare's approach to detecting EMR fraud

January 14, 2013 Kevin 1
…

Tagged as: Geriatrics, Hospital-Based Medicine

Post navigation

< Previous Post
Is it justifiable to judge a paper by its author or funding source?
Next Post >
Trust but verify: Medicare's approach to detecting EMR fraud

More by Ken Covinsky, MD

  • a desk with keyboard and ipad with the kevinmd logo

    Surrogate decision making: Families are much more than visitors

    Ken Covinsky, MD
  • a desk with keyboard and ipad with the kevinmd logo

    Long term care insurance: The premium catch

    Ken Covinsky, MD
  • a desk with keyboard and ipad with the kevinmd logo

    Stop cancer screening in patients with dementia

    Ken Covinsky, MD

More in Conditions

  • The surprising medical mystery of a “good” Hitler: How a rescued kitten revealed a rare movement disorder

    Teresella Gondolo, MD
  • The power of coaching for physicians: transforming thoughts, changing lives

    Kim Downey, PT
  • Unlocking the secrets of cancer conferences: an end-of-life counselor’s journey among pharmaceutical giants

    Althea Halchuck, EJD
  • An obstetrician-gynecologist reveals the truth about reproductive planning and how to navigate society’s expectations

    Yuliya Malayev, DO, MPH
  • Nose-brain connection: The surprising link between allergies and mental health revealed

    Kara Wada, MD
  • Is the rise in mental illness due to greater awareness or a true increase in incidence?

    Zahid Awan, MD
  • Most Popular

  • Past Week

    • A patient’s perspective on the diminishing relationship between doctors and patients

      Michele Luckenbaugh | Conditions
    • Unmasking wage disparity in health care: the truth behind the Elmhurst Hospital physician strike

      Kevin Pho, MD | KevinMD
    • Why affirmative action is crucial for health equity and social justice in medicine

      Katrina Gipson, MD, MPH | Policy
    • How electronic health records preserve patients’ legacies in the words of oncologists

      Marc Braunstein, MD, PhD | Physician
    • Unmasking the brutal reality of gun violence in America: a call to action for unity and meaningful change

      Osmund Agbo, MD | Policy
    • Emulating Michael Jordan’s winning mindset: a path to success for health care professionals and entrepreneurs

      Harvey Castro, MD, MBA | Physician
  • Past 6 Months

    • The growing threat to transgender health care: implications for patients, providers, and trainees

      Carson Hartlage | Policy
    • Breaking point: the 5 reasons American doctors are dreaming of walking away from medicine

      Amol Shrikhande, MD | Physician
    • “Is your surgeon really skilled? The hidden threat to public safety in medicine.

      Gene Uzawa Dorio, MD | Physician
    • It’s time to replace the 0 to 10 pain intensity scale with a better measure

      Mark Sullivan, MD and Jane Ballantyne, MD | Conditions
    • Breaking the cycle of racism in health care: a call for anti-racist action

      Tomi Mitchell, MD | Policy
    • Revolutionize your practice: the value-based care model that reduces physician burnout

      Chandravadan Patel, MD | Physician
  • Recent Posts

    • The hidden factor in physician burnout: How the climate crisis is contributing to the erosion of well-being

      Elizabeth Cerceo, MD | Physician
    • The surprising medical mystery of a “good” Hitler: How a rescued kitten revealed a rare movement disorder

      Teresella Gondolo, MD | Conditions
    • The power of coaching for physicians: transforming thoughts, changing lives

      Kim Downey, PT | Conditions
    • Why doctors aren’t to blame for the U.S. opioid crisis [PODCAST]

      The Podcast by KevinMD | Podcast
    • Raw humanity on night float: inspiring patient encounters and overcoming challenges

      Johnathan Yao, MD, MPH | Physician
    • Is AI the solution for the shortage of nephrologists? ChatGPT weighs in.

      Amol Shrikhande, MD | Tech

Subscribe to KevinMD and never miss a story!

Get free updates delivered free to your inbox.


Find jobs at
Careers by KevinMD.com

Search thousands of physician, PA, NP, and CRNA jobs now.

Learn more

View 5 Comments >

Founded in 2004 by Kevin Pho, MD, KevinMD.com is the web’s leading platform where physicians, advanced practitioners, nurses, medical students, and patients share their insight and tell their stories.

Social

  • Like on Facebook
  • Follow on Twitter
  • Connect on Linkedin
  • Subscribe on Youtube
  • Instagram

CME Spotlights

From MedPage Today

Latest News

  • 'Medically Relevant to Saving the Life of Your Patient': What We Heard This Week
  • Want to Solve the Nurse Shortage?
  • Why Are Female Doctors Sued Nearly Half as Often as Male Doctors?
  • What Drug Did FDA Just Approve for COVID?
  • PET Scan for Alzheimer's Dx; Predicting Colon Cancer Survival

Meeting Coverage

  • No Access to Routine Healthcare Biggest Barrier to HPV Vaccination
  • Trial Results Spark Talk of Curing More Metastatic Cervical Cancers
  • Cross-Border Collaboration Improves Survival in Pediatric Leukemia Patients
  • Monoclonal Antibody Reduced Need For Transfusions in Low-Risk MDS
  • Less-Invasive Surgery for Pancreatic Cancer Proves Safe, Effective
  • Most Popular

  • Past Week

    • A patient’s perspective on the diminishing relationship between doctors and patients

      Michele Luckenbaugh | Conditions
    • Unmasking wage disparity in health care: the truth behind the Elmhurst Hospital physician strike

      Kevin Pho, MD | KevinMD
    • Why affirmative action is crucial for health equity and social justice in medicine

      Katrina Gipson, MD, MPH | Policy
    • How electronic health records preserve patients’ legacies in the words of oncologists

      Marc Braunstein, MD, PhD | Physician
    • Unmasking the brutal reality of gun violence in America: a call to action for unity and meaningful change

      Osmund Agbo, MD | Policy
    • Emulating Michael Jordan’s winning mindset: a path to success for health care professionals and entrepreneurs

      Harvey Castro, MD, MBA | Physician
  • Past 6 Months

    • The growing threat to transgender health care: implications for patients, providers, and trainees

      Carson Hartlage | Policy
    • Breaking point: the 5 reasons American doctors are dreaming of walking away from medicine

      Amol Shrikhande, MD | Physician
    • “Is your surgeon really skilled? The hidden threat to public safety in medicine.

      Gene Uzawa Dorio, MD | Physician
    • It’s time to replace the 0 to 10 pain intensity scale with a better measure

      Mark Sullivan, MD and Jane Ballantyne, MD | Conditions
    • Breaking the cycle of racism in health care: a call for anti-racist action

      Tomi Mitchell, MD | Policy
    • Revolutionize your practice: the value-based care model that reduces physician burnout

      Chandravadan Patel, MD | Physician
  • Recent Posts

    • The hidden factor in physician burnout: How the climate crisis is contributing to the erosion of well-being

      Elizabeth Cerceo, MD | Physician
    • The surprising medical mystery of a “good” Hitler: How a rescued kitten revealed a rare movement disorder

      Teresella Gondolo, MD | Conditions
    • The power of coaching for physicians: transforming thoughts, changing lives

      Kim Downey, PT | Conditions
    • Why doctors aren’t to blame for the U.S. opioid crisis [PODCAST]

      The Podcast by KevinMD | Podcast
    • Raw humanity on night float: inspiring patient encounters and overcoming challenges

      Johnathan Yao, MD, MPH | Physician
    • Is AI the solution for the shortage of nephrologists? ChatGPT weighs in.

      Amol Shrikhande, MD | Tech

MedPage Today Professional

An Everyday Health Property Medpage Today
  • Terms of Use | Disclaimer
  • Privacy Policy
  • DMCA Policy
All Content © KevinMD, LLC
Site by Outthink Group

Bed alarms don’t work and won’t reduce patient falls
5 comments

Comments are moderated before they are published. Please read the comment policy.

Loading Comments...