Time Spent on Floor After Falls of Frailty People Overnight

NCT ID: NCT03116386

Last Updated: 2018-04-10

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

Get a concise snapshot of the trial, including recruitment status, study phase, enrollment targets, and key timeline milestones.

Recruitment Status

WITHDRAWN

Clinical Phase

NA

Study Classification

INTERVENTIONAL

Study Start Date

2017-01-20

Study Completion Date

2019-05-31

Brief Summary

Review the sponsor-provided synopsis that highlights what the study is about and why it is being conducted.

In the context of reduce staff for supervision of dependent elderly, automated risk alert systems could have a positive impact on the organization of night care by better targeting monitoring. Residents' sleep could be less affected with use of automatic alert system than by systematic monitoring visits. One study shows an improvement in the humor of residents after the use of such a system.

The hypothesis of the study is that the use of a bed-raising detection system linked with the activation of a lighting environment and a caregivers alert system (Etolya-F® gerontechnology device, Anaxi Technology Company) would reduce intervention time in this population, thus limiting the time spent on floor and its physical and psychological consequences.

Detailed Description

Dive into the extended narrative that explains the scientific background, objectives, and procedures in greater depth.

In France in 2011, more than 575000 elderly lived in long term care facilities. Most of them had comorbidities.

The most frequent reason for admitting in long term care facilities is the worsening of health status of elderly, often triggered by a fall. Elderly living in long term care facilities have frequently several comorbidities; the first ones are Alzheimer and related diseases. The proportion of such very dependent institutionalized people has risen for the last recent years and they represent a population at very high risk of falling. In an epidemiological analysis of more than 70,000 falls from residents of Bavarian nursing homes, the prevalence of fall was estimated at 1.49 falls for women and 2.18 for men. Those results didn't take into account the fact that people could fall more than once a day. In Alzheimer people (or people with related diseases) who lived in long term care facilities, the incidence of falls was even highest with 2.7 falls per resident per year.

The consequences of falls are not only physical injuries (wounds, fractures); they are frequently associated with psychological repercussions as loss of self-confidence, fear of new falls, reduction of abilities of moving which lead into declining of daily activities and loss of autonomy.

The incapacity of getting up alone is reported by more than a third of patients who have fallen, even if the fall is not complicated by a fracture. The length of time people stay on floor is directly link to the ability of the elderly person to give an alarm and to the presence or not of someone else to help him/her to get up. Patients who live in long term care facilities have limited functional capabilities not compatible with an operational use of active alarm systems.

In long term care facilities, 30-40% of falls occur between 8pm and 8am. Falls occurring at night seem to be associated with more severe injuries. Staff are less numerous at night with only 3 to 4 caregivers for 100 people.

To the best of the knowledge of the investigators, delay intervention time after a fall occurring at night has never been studied. Based on the investigators' experience, elderly people can only be discovered and helped when caregivers find them on floor on the occasion of a planned surveillance visit. These visits are carried out every 2 to 4 hours at night.

Automated alarms are used to alert staff to situations where there is a high risk of falling: an attempt to lift an armchair from a person who cannot stand or to detect the night-time rise of a high-risk people with the use of various sensors (pressure sensors connected to the mattress or environmental sensors).

In the context of staff reduced at night for the supervision of dependent elderly, automated risk alert systems could also have a positive impact on the organization of night care by better targeting monitoring. Residents' sleep could be less affected with use of automatic alert system than by systematic monitoring visits. One study shows an improvement in the humor of residents after the use of such a system.

The hypothesis of the study is that the use of a bed-raising detection system linked with the activation of a lighting environment and a personnel alert system (Etolya-F® gerontechnology device, Anaxi Technology Company) would reduce intervention time in this population, thus limiting the time spent on floor and its physical and psychological consequences.

Conditions

See the medical conditions and disease areas that this research is targeting or investigating.

Dependence Fall From Bed Fall Injury Fall in Nursing Home Cognition Disorders

Study Design

Understand how the trial is structured, including allocation methods, masking strategies, primary purpose, and other design elements.

Allocation Method

NON_RANDOMIZED

Intervention Model

SEQUENTIAL

Run-in period then 6 months control period and then 6 months experimental period with activation of all the functions of Etolya-F® (the device used in the study)
Primary Study Purpose

DEVICE_FEASIBILITY

Blinding Strategy

NONE

Study Groups

Review each arm or cohort in the study, along with the interventions and objectives associated with them.

run-in period

In order to improve the precision of data, the run-in period is dedicated to sensitize the caregivers about the importance of

* reporting all the falls occurring during the night
* tracking in each resident's file, all informations about the estimate length of time spent on floor after a fall occurring during the night
* and also reporting every other events occuring at night as wandering. All the beds will progressively equipped with the Etolya-F ® devices but the Etolya-F ® ddevices will stay off.

Group Type OTHER

run-in period

Intervention Type OTHER

observational time i.e. baseline situation

control period

We expect 30 falls will occurr at night during this 6 months period. Etolya-F ® devices will be installed on the bed of all participant residents but with limited fonctionnalities i.e. only the length of absence in the bed will be recorded (difference between time of detection of the beginning of absence in the bed and time where the resident will be found by the caregivers out of his bed).

Group Type SHAM_COMPARATOR

Control period

Intervention Type DEVICE

neither activation of any lighting environment when the resident gets up from his bed nor alert if the resident did not return to bed after 15 minutes Etolya-F ® devices will only permit detection and recording of the moment of the elderlly will leave his/her bed and recording of the moment the elderly will be found by caregivers

Etolya-F ® devices

We also expect 30 falls will occur at night during this 6-month period. Etolya-F ® devices will be used with all their functionalities i.e. permit detection of absence in the bed, activation of a lighting environment when the resident gets up from his bed, transmission of alert to caregivers through the centralized system of sick call if the resident do not return to bed after 15 minutes and recording the time when caregivers will find the resident out of bed, distinguishing between a fall and a night wandering in the room or corridors without a fall

Group Type EXPERIMENTAL

Etolya-F ® devices

Intervention Type DEVICE

Etolya-F ® devices will permit detection of absence in the bed, activation of a lighting environment when the resident gets up from his bed, transmission of alert to caregivers through the centralized system of sick call if the resident do not return to bed after 15 minutes and recording the time when caregivers will find the resident out of bed, distinguishing between a fall and a night wandering in the room or corridors without a fall

Interventions

Learn about the drugs, procedures, or behavioral strategies being tested and how they are applied within this trial.

run-in period

observational time i.e. baseline situation

Intervention Type OTHER

Control period

neither activation of any lighting environment when the resident gets up from his bed nor alert if the resident did not return to bed after 15 minutes Etolya-F ® devices will only permit detection and recording of the moment of the elderlly will leave his/her bed and recording of the moment the elderly will be found by caregivers

Intervention Type DEVICE

Etolya-F ® devices

Etolya-F ® devices will permit detection of absence in the bed, activation of a lighting environment when the resident gets up from his bed, transmission of alert to caregivers through the centralized system of sick call if the resident do not return to bed after 15 minutes and recording the time when caregivers will find the resident out of bed, distinguishing between a fall and a night wandering in the room or corridors without a fall

Intervention Type DEVICE

Eligibility Criteria

Check the participation requirements, including inclusion and exclusion rules, age limits, and whether healthy volunteers are accepted.

Inclusion Criteria

* elderly people who are resident in long term care facilities
* non opposed to participate to the study or whose his/her legal representative is not opposed to the participation of the resident to the study

Exclusion Criteria

* the resident's bed can not be equipped with the ETOLYA-F® device for any reason
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

Meet the organizations funding or collaborating on the study and learn about their roles.

Centre Hospitalier Annecy Genevois

OTHER

Sponsor Role lead

Responsible Party

Identify the individual or organization who holds primary responsibility for the study information submitted to regulators.

Responsibility Role SPONSOR

Principal Investigators

Learn about the lead researchers overseeing the trial and their institutional affiliations.

Dr Matthieu DEBRAY, MD

Role: STUDY_DIRECTOR

CH Annecy Genevois

Dr Nathalie RUEL, MD

Role: PRINCIPAL_INVESTIGATOR

CH Annecy Genevois

Locations

Explore where the study is taking place and check the recruitment status at each participating site.

Résidence St François CH ANNECY-GENEVOIS

Annecy, , France

Site Status

Countries

Review the countries where the study has at least one active or historical site.

France

References

Explore related publications, articles, or registry entries linked to this study.

Rapp K, Becker C, Cameron ID, Konig HH, Buchele G. Epidemiology of falls in residential aged care: analysis of more than 70,000 falls from residents of bavarian nursing homes. J Am Med Dir Assoc. 2012 Feb;13(2):187.e1-6. doi: 10.1016/j.jamda.2011.06.011. Epub 2011 Aug 4.

Reference Type BACKGROUND
PMID: 21816682 (View on PubMed)

Pellfolk T, Gustafsson T, Gustafson Y, Karlsson S. Risk factors for falls among residents with dementia living in group dwellings. Int Psychogeriatr. 2009 Feb;21(1):187-94. doi: 10.1017/S1041610208007837. Epub 2008 Oct 6.

Reference Type BACKGROUND
PMID: 18834557 (View on PubMed)

Jensen J, Lundin-Olsson L, Nyberg L, Gustafson Y. Falls among frail older people in residential care. Scand J Public Health. 2002;30(1):54-61.

Reference Type BACKGROUND
PMID: 11928835 (View on PubMed)

Vu MQ, Weintraub N, Rubenstein LZ. Falls in the nursing home: are they preventable? J Am Med Dir Assoc. 2006 Mar;7(3 Suppl):S53-8, 52. doi: 10.1016/j.jamda.2005.12.016.

Reference Type BACKGROUND
PMID: 16500282 (View on PubMed)

Lach HW, Parsons JL. Impact of fear of falling in long term care: an integrative review. J Am Med Dir Assoc. 2013 Aug;14(8):573-7. doi: 10.1016/j.jamda.2013.02.019. Epub 2013 Apr 16.

Reference Type BACKGROUND
PMID: 23602257 (View on PubMed)

Fleming J, Brayne C; Cambridge City over-75s Cohort (CC75C) study collaboration. Inability to get up after falling, subsequent time on floor, and summoning help: prospective cohort study in people over 90. BMJ. 2008 Nov 17;337:a2227. doi: 10.1136/bmj.a2227.

Reference Type BACKGROUND
PMID: 19015185 (View on PubMed)

Bergland A, Laake K. Concurrent and predictive validity of "getting up from lying on the floor". Aging Clin Exp Res. 2005 Jun;17(3):181-5. doi: 10.1007/BF03324594.

Reference Type BACKGROUND
PMID: 16110729 (View on PubMed)

Lester P, Haq M, Vadnerkar A, Feuerman M. Falls in the nursing home setting: does time matter? J Am Med Dir Assoc. 2008 Nov;9(9):684-6. doi: 10.1016/j.jamda.2008.06.007. Epub 2008 Sep 25.

Reference Type BACKGROUND
PMID: 18992702 (View on PubMed)

Pelissier C, Vohito M, Fort E, Sellier B, Agard JP, Fontana L, Charbotel B. Risk factors for work-related stress and subjective hardship in health-care staff in nursing homes for the elderly: A cross-sectional study. J Occup Health. 2015;57(3):285-96. doi: 10.1539/joh.14-0090-OA. Epub 2015 Apr 10.

Reference Type BACKGROUND
PMID: 25864937 (View on PubMed)

Capezuti E, Brush BL, Lane S, Rabinowitz HU, Secic M. Bed-exit alarm effectiveness. Arch Gerontol Geriatr. 2009 Jul-Aug;49(1):27-31. doi: 10.1016/j.archger.2008.04.007. Epub 2008 Jun 3.

Reference Type BACKGROUND
PMID: 18508138 (View on PubMed)

Banerjee S, Steenkeste F, Couturier P, Debray M, Franco A. Telesurveillance of elderly patients by use of passive infra-red sensors in a 'smart' room. J Telemed Telecare. 2003;9(1):23-9. doi: 10.1258/135763303321159657.

Reference Type BACKGROUND
PMID: 12641889 (View on PubMed)

Lipsitz LA, Tchalla AE, Iloputaife I, Gagnon M, Dole K, Su ZZ, Klickstein L. Evaluation of an Automated Falls Detection Device in Nursing Home Residents. J Am Geriatr Soc. 2016 Feb;64(2):365-8. doi: 10.1111/jgs.13708. Epub 2016 Jan 19.

Reference Type BACKGROUND
PMID: 26783046 (View on PubMed)

Tinetti ME, Williams CS. Falls, injuries due to falls, and the risk of admission to a nursing home. N Engl J Med. 1997 Oct 30;337(18):1279-84. doi: 10.1056/NEJM199710303371806.

Reference Type BACKGROUND
PMID: 9345078 (View on PubMed)

Parker MJ, Gillespie WJ, Gillespie LD. Effectiveness of hip protectors for preventing hip fractures in elderly people: systematic review. BMJ. 2006 Mar 11;332(7541):571-4. doi: 10.1136/bmj.38753.375324.7C. Epub 2006 Mar 2.

Reference Type BACKGROUND
PMID: 16513687 (View on PubMed)

Related Links

Access external resources that provide additional context or updates about the study.

http://www.ladocumentationfrancaise.fr/var/storage/rapports-publics/074000390.pdf

New technologies likely to improve gerontological practices and the daily life of elderly patients and their families

Other Identifiers

Review additional registry numbers or institutional identifiers associated with this trial.

2016-A01799-42

Identifier Type: -

Identifier Source: org_study_id

More Related Trials

Additional clinical trials that may be relevant based on similarity analysis.

Preliminary Clinical Trial- FallScape-D
NCT06656897 ACTIVE_NOT_RECRUITING EARLY_PHASE1