title: Development and pilot study of a bed-exit alarm based on a body-worn accelerometer.
abstract: BACKGROUND
  Falls are a major problem in hospitals and nursing homes. The consequences of falls can be severe, both for the individual and for the caring institution.
  
  
  OBJECTIVE
  The aim of the work presented here is to reduce the number of falls on a geriatric ward by monitoring patients more closely. To achieve this goal, a bed-exit alarm that reliably detects an attempt to get up has been constructed.
  
  
  METHODS
  A requirements analysis revealed the nurses' and physicians' needs and preferences. Based on the gathered information, an incremental design process generated different prototypes. These were tested for the reliability of their ability to detect attempts to get up in both laboratory settings and with geriatric patients. Based on the result of these tests, a scalable technical solution has been developed and proven its reliability in a 1-year, randomized controlled pilot clinical trial on a geriatric ward.
  
  
  RESULTS
  The developed system is unobtrusive and easy to deploy. It has been tested in laboratory settings, usability tests and a 1-year randomized clinical trial with 98 patients. This paper focuses on the technical development of the system. We present different prototypes, the experiments and the pilot study used to evaluate their performance. Last but not least, we discuss the lessons learned so far.
  
  
  CONCLUSIONS
  The developed bed-exit alarm is able to reliably detect patients' attempts to get up. The results of the clinical trial show that the system is able to reduce the number of falls on a geriatric ward. Next steps are the design of a specialized sensor node that is easier to use and can be applied on an even larger scale due to its reduced cost. A multicenter trial with a larger number of patients is required to confirm the results of this pilot study.
authors.affiliation: Peter L. Reichertz Institute for Medical Informatics University of Braunschweig - Institute of Technology and Hannover Medical School, Mühlenpfordtstr. 23, 38106, Braunschweig, Germany, Klaus-Hendrik.Wolf@plri.de.
authors.forename: K-H
authors.initials: KH
authors.lastname: Wolf
authors.forename: K
authors.initials: K
authors.lastname: Hetzer
authors.forename: H M
authors.initials: HM
authors.lastname: zu Schwabedissen
authors.forename: B
authors.initials: B
authors.lastname: Wiese
authors.forename: M
authors.initials: M
authors.lastname: Marschollek
mesh_terms: D000054:Acceleration; D000058:Accidental Falls / Q000517:prevention & control*; D056044:Actigraphy / Q000295:instrumentation*; D000368:Aged; D000369:Aged, 80 and over; D056902:Clinical Alarms; D004867:Equipment Design; D019544:Equipment Failure Analysis; D005260:Female; D006801:Humans; D008297:Male; D018670:Monitoring, Ambulatory / Q000295:instrumentation*; D010865:Pilot Projects; D059015:Wireless Technology / Q000295:instrumentation*