Evaluation of a digital solution that helps prevent falls and reduce manual turn checks

The Academic Health Science Network for the North East and North Cumbria (AHSN NENC) undertook a real-world evaluation (RWE) on the Vitalerter innovation which claims to reduce falls and manual turn checks. The RWE aimed to establish Vitalerter’s effectiveness in these areas. For this project, utilising funding provided by the Department of Health and Social Care (Digitising Social Care), the AHSN NENC worked together with a North East care home provider and a dedicated project team which included Porters Care (supplier of the Vitalerter solution), Durham County Council and the University of Sunderland. The aims of the independent Real World Evaluation (RWE) were: –

  1. How effective is the Vitalerter solution in preventing falls?
  2. How effective is the Vitalerter solution in reducing turn checks for residents?
  3. What are the key (known/unknown) qualitative and quantitative benefits (cashable/non-cashable) that will apply to care homes, care home staff, supporting clinical services/staff and the care home residents themselves?
  4. Is the solution viable to rollout out on a larger scale across area and the wider NENC region?

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Project Dates

Project Start 01/12/2022
Project End 31/07/2023

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It has reduced falls, reduced injuries, and hospital admissions
Deputy care home manager
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Falls can have a huge impact on the lives of care home residents, their family and friends and those individuals and services that provide their care. In England, the population of those aged 65 years and older experience approximately 255, 000, falls-related hospital admissions annually (PHE, 2017).

In care homes falls can lead to a person becoming more dependent (due to injury, reluctance to mobilise etc) along with an increased workload for the staff to maintain the necessary levels of care. Pressure ulcers are also prevalent in care homes, which results in the need for a turn protocol to be put in place which involves waking the resident several times in the night to manually turn them.

By deploying the Vitalerter solution and its alert functionality it is expected to realise benefits associated with a reduction in falls and reduction of manual turns necessary for pressure ulcer management.

The “Vitalerter” solution (supplied by Porters Care) is an under bed contactless sensor that can monitor movement in bed which can help prevent falls and reduce manual turn checks. The system alerts staff when the resident is about to get out of bed and if a resident needs turned. The system also continually monitors a resident’s health through breathing and heart rate sensors. It can also monitor room temperature and air quality should the bed be compromised in the case of incontinence.

In summary, it can provide evidence of sleep patterns, heart rates, respiratory rates, stroke volume, heart rate variability, movement, and relaxation. All this data can be utilised to assist nurses and caregivers to provide timely and better care with real-time monitoring, proactive alerts, and response systems.

Supported by staff from the care home provider and Porters Care as the supplier, 30 devices were deployed in 6 care homes within the County Durham area over a three-month period. Residents were selected to either use the device for falls prevention alerts or turn alerts (alert data monitoring only to establish potential benefit i.e., no operational procedures were changed, and staff continued to carry out the turn protocols required). The University of Sunderland carried out an independent RWE evaluation of the solution and provided a report to outline the outcomes. Three months baseline data and three months evaluation data were collected to carry out the quantitative analysis. Several staff interviews were completed to provide the qualitative information. The report was also complimented by extensive background research and being engaged with project outputs and attending key meetings to gain further perspectives on its success.

Please see the resources section for in-depth impacts of this project with associated data.

The headline impacts are –

  • Vitalerter contributed to a significant reduction in falls (31 less falls or 53% reduction against baseline) from the 15 devices deployed. Falls did not increase for any resident and there were several instances where no falls occurred since the device was installed.
  • The Vitalerter solution resulted in a statistically significant reduction in the estimated number of manual turns required, which highlighted a significant number of days the resident wouldn’t need turning and therefore a reduction in manual turns required by the care home staff.
  • The resulting reduction in falls means care homes staff time are utilised more effectively.

The solution is viable to roll out on a larger scale, however this is conditional on some necessary changes to improve user experience. Several challenges of using the Vitalerter were also identified including:

Technological challenges (Low battery power, over-sensitivity, lack of flexibility regarding placement of the device, alert notifications either taking too long to come through to the handset or not coming through, device freezing).

Practical challenges (Supply and demand per care home size, number of residents allocated devices and assessment of need for the device were identified i.e potential lack of benefits due to the resident not requiring the device.

Whilst some participants felt there was no changes required, most felt some changes would be beneficial. Some practical suggestions were made:

    • Participants highlighted the value of linking the Vitalerter system with nursing systems already in place and thus remove the need for a separate handset.
    • More flexible with its continuous monitoring (e.g., pause or stop monitoring when the resident not in bed – reduce overburdening care workers with false alerts)
    • Care workers to be involved in the allocation of Vitalerter’s, whereby their knowledge and insight could be used to better inform the decision-making process.
    • Requires stable and sufficient network connectivity (send alerts notifications/potential missing data).

A further discussion can be found in the full evaluation report which documents further suggestions for advancements in the technology, the deployment and training of Vitalerter.

  • Reduction in falls
    • Reduced time consuming falls-related paperwork.
    • Reduction in one-to-one support when a resident falls and requires support and medical attention.
    • A more even distribution of care worker time among residents who were/were not categorised as fall risks.
    • Improvements in the provision of person-centred practice.
  • Reduce manual turns
    • Greater comfort and quality of sleep for residents in the future.
    • A greater distribution of staff time
    • Less physical strain of staff members
  • General
    • Staff reported improvements in wellbeing and decreased work-related stress, indicating the potential for reduced staff sickness.

The AHSN NENC provided programme and project oversight from identifying the solution to ensuring the project delivered the intended deliverables, working closely with the project team and engaging with the relevant stakeholders that were key to its successful completion.

The AHSN NENC supported the teams with programme and projects oversight, including engagement events, communications, and support resources.

As soon as it goes off, we get there straight away before there's any incidents and it just reduces the risks.
Senior Care Worker