Health technologies for the prevention and detection of falls in adult hospital inpatients: a scoping review

Abstract

Objective: The objective of this scoping review was to examine and map the evidence relating to the reporting and evaluation of technologies for the prevention and detection of falls in adult hospital inpatients.Introduction: Falls are a common cause of accidental injury, leading to a significant safety issue in hospitals globally, and resulting in substantial human and economic costs. Previous research has focused on community settings with less emphasis on hospital settings to date. Inclusion criteria: Participants included adult inpatients, aged 18 years and over; Concept included the use of fall prevention or detection technologies; Context included any hospital ward setting. Methods: This scoping review was conducted according to Joanna Briggs Institute (JBI) methodology for scoping reviews, guided by an a-priori protocol. A wide selection of databases including Medline, CINAHL, AMED, EmBASE, PEDro, Epistimonikos, and Science Direct were searched for records from inception to October 2019. Other sources included grey literature, trial registers, government health department websites and websites of professional bodies. Only studies in the English language were included. A three-step search strategy was employed with all records exported for subsequent title and abstract screening, prior to full text screening. Screening was performed by two independent reviewers and data extraction by one reviewer following agreement checks. Data is presented in narrative and tabular form.Results: Over 13,000 records were identified with 404 included in the scoping review: 336 reported on fall prevention technologies, 51 targeted detection and 17 concerned both. The largest contributions of studies came from the USA (n=185), Australia (n=65), UK (n=36) and Canada (n=18).There was a variety of study designs including 77 prospective cohort studies, 33 before-after studies and a large number of systematic reviews (n=35). However, relatively few randomised controlled trials were conducted (n=25). The majority of records reported on multifactorial and multicomponent technologies (n=178), followed by fall detection devices (n=86). Few studies reported on the following interventions in isolation: fall risk assessment (n=6), environment design (n=8), sitters (n=5), rounding (n=3), exercise (n=3), medical/pharmaceutical (n=2), physiotherapy (n=1) and nutritional (n=1). The majority (56%) of studies reported clinical effectiveness outcomes with smaller numbers (14%) reporting feasibility and/or acceptability outcomes, or cost-effectiveness outcomes (5%). Conclusions:This review has mapped the literature on falls prevention and detection technology and outcomes for adults in the hospital setting. Despite the volume of available literature, there remains a need for further high-quality research on fall prevention and detection technologies.

Moving from consultation to co-creation with knowledge users in scoping reviews: guidance from the JBI Scoping Review Methodology Group

“…from the results to be fully explored and identified. 32 A similar approach was also taken in a recent scoping review on medical education, where, once the researchers had gathered preliminary findings, knowledge users were asked to check whether the findings resonated with their experience. The authors then asked the knowledge users to suggest topics for discussion and future research.…”

“…A recent scoping review on fall prevention and detection technologies for adult hospital in-patients involved a mixed review team including evidence synthesis methodologists, an information specialist, service users, a geriatrician, as well as a Falls Lead, Patient Safety Manager and Lead Moving and Handling Facilitator from a local health board 32 . The contribution from all partners enabled the “so what?” questions (what do the results tell us and what should we do now?)…”

“…The contribution from all partners enabled the “so what?” questions (what do the results tell us and what should we do now?) from the results to be fully explored and identified 32 …”

The effectiveness of multifactorial and multicomponent interventions for the prevention of falls for adults in hospital settings: a systematic review and meta-analysis

“…The search strategy for this review was part of a larger scoping review investigating general approaches to adult falls prevention and detection in hospital settings [9]. The search strategy was developed in consultation with a research librarian, with the aim of identifying published and unpublished literature.…”

“…During full-text screening for the larger scoping review [9], relevant studies were identified as being suitable for inclusion in this effectiveness review.…”