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Stephen K, Campbell A. The experiences of older adults with cognitive impairment in using falls prevention alarms in hospital: A qualitative descriptive study. Aust Occup Ther J 2024; 71:132-148. [PMID: 38016634 DOI: 10.1111/1440-1630.12917] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Revised: 10/29/2023] [Accepted: 11/01/2023] [Indexed: 11/30/2023]
Abstract
INTRODUCTION Bed and chair sensor alarms are commonly used for falls prevention in hospitals, despite questionable efficacy. Research analysing older adults' experiences of alarms is scarce, and adults with cognitive impairment are consistently excluded. AIM The aim of this study was to explore how older adults with cognitive impairment perceive and experience falls prevention alarms in hospital. METHOD A qualitative descriptive design investigated older adults' experiences of alarms in a Geriatric Evaluation and Management ward in Melbourne. Patients were included if they had been provided an alarm. Semi-structured interviews were the primary method of data collection with two observation sessions and medical record analyses completed to enable triangulation of findings. Data were subjected to thematic analysis, and the Person-Environment-Occupation framework was chosen to add insight into the complexities of older adults' experiences of alarms. FINDINGS All 11 participants had a level of cognitive impairment with delirium, confusion, or impulsiveness recorded in their medical file. Two overarching themes were identified: communication and collaboration with staff and rationalisation of alarm use. Participants' perceived staff were focussed on falls prevention but experienced a lack of communication about the purpose of alarms. Participants wanted an individualised approach to alarms. Some were comforted with the thought of alarms alerting staff, making them feel well cared for and believed alarms were a useful 'back-up'. Others found alarms uncomfortable, frustrating, and restricting. Application of the Person-Environment-Occupation framework provided insight into how enabling and restrictive factors can impact whether the alarm is experienced positively or negatively. Seven unwitnessed falls occurred during the participants' admissions. Thirty-four per cent of alarm triggers observed were considered false alerts. CONCLUSION Older adults commonly reported negative experiences using bed/chair sensor alarms. Occupational therapists have the training to collaborate with people with cognitive impairment and assess the usefulness of alarms in reducing falls, based on how they interact with the older adult's unique person, environment, and occupation domains.
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Affiliation(s)
- Kelly Stephen
- College of Nursing and Health sciences, Flinders University, Adelaide, South Australia, Australia
- Eastern Health, Box Hill, Victoria, Australia
- School of Primary and Allied Healthcare, Monash University Peninsula Campus, Frankston, Victoria, Australia
| | - Alison Campbell
- College of Nursing and Health sciences, Flinders University, Adelaide, South Australia, Australia
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2
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Tay JL, Xie HT. Novel interventions significantly reduce falls with fractures: A meta-analysis and systematic review. Geriatr Nurs 2023; 52:181-190. [PMID: 37390566 DOI: 10.1016/j.gerinurse.2023.06.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Revised: 06/06/2023] [Accepted: 06/06/2023] [Indexed: 07/02/2023]
Abstract
INTRODUCTION Worldwide, falls lead to possible complications such as prolonged hospitalization, prolonged bed rest, pressure injuries, fractures and mortality. AIMS The study aimed to evaluate the effectiveness of novel fall prevention strategies that utilized technology in preventing falls. METHODS The meta-analysis and systematic review was guided by the Cochrane guidelines for systematic reviews of interventions. The authors searched databases for specified keywords. RESULTS A total of 22 studies were included. Interventions included multi-modal fall prevention interventions, camera surveillance, motion sensors and bed/chair exit alarms. Video monitoring was equivocal in reducing fall rates. Exit alarms statistically significantly reduce falls between groups but not within groups. The interventions were not statistically significant in reducing falls with minor injuries but they were statistically significant in reducing falls with serious injuries including fractures. CONCLUSION A comprehensive fall prevention care plan, rather than one specific intervention, is necessary to prevent falls effectively.
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Affiliation(s)
- Jing Ling Tay
- Institute of Mental Health, Buangkok Green Medical Park, 10 Buangkok View, Singapore 539747, Singapore.
| | - Hui Ting Xie
- Institute of Mental Health, Buangkok Green Medical Park, 10 Buangkok View, Singapore 539747, Singapore
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3
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Huter K, Krick T, Domhoff D, Seibert K, Wolf-Ostermann K, Rothgang H. Effectiveness of Digital Technologies to Support Nursing Care: Results of a Scoping Review. J Multidiscip Healthc 2020; 13:1905-1926. [PMID: 33328736 PMCID: PMC7734078 DOI: 10.2147/jmdh.s286193] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Accepted: 11/05/2020] [Indexed: 12/19/2022] Open
Abstract
Background The field of digital technologies being developed or applied to support nursing care is extensive. The aim of this scoping review is to provide an overview on technologies for which results on positive or negative effects on persons in need of care, caregivers or care institutions are available and to appraise the reliability of these results. Methods A scoping review design has been used to identify studies focussing on the effectiveness of digital technologies in nursing care for persons in need of care, caregivers or care institutions. The screening process included 19,510 scientific publications from 9 databases. Results A total of 123 single studies and 31 reviews were subjected to the analysis. The included technologies comprise nursing and health information technologies, such as assistive devices, information and communication technologies, sensors and robotics. The results show that there are many studies that demonstrate positive effects, but the level of evidence is mostly low and study sizes are often small. Hardly any technology has been researched intensively enough to produce conclusive results. Studies on a high level of evidence (RCTs) lack for most technological areas. Heterogeneous results in some areas indicate that effects may depend strongly on the mode and specific context into which the technologies are introduced. Conclusion Due to the limited evidence on effectiveness of digital technologies in nursing care, it is not surprising that care institutions are reluctant to put innovative technologies into practice. The scoping review indicates technology areas that should be subject to future research with higher quality studies. Research on outpatient, informal and cross-sectoral care should be intensified to further exploit the potential of digital technologies with a view to improving independence of care-recipients and unburdening formal and informal carers.
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Affiliation(s)
- Kai Huter
- University of Bremen, SOCIUM Research Center on Inequality and Social Policy, Bremen, Germany.,University of Bremen, High-Profile Area of Health Sciences, Bremen, Germany
| | - Tobias Krick
- University of Bremen, SOCIUM Research Center on Inequality and Social Policy, Bremen, Germany.,University of Bremen, High-Profile Area of Health Sciences, Bremen, Germany
| | - Dominik Domhoff
- University of Bremen, High-Profile Area of Health Sciences, Bremen, Germany.,University of Bremen, Institute for Public Health and Nursing Research, Bremen, Germany
| | - Kathrin Seibert
- University of Bremen, High-Profile Area of Health Sciences, Bremen, Germany.,University of Bremen, Institute for Public Health and Nursing Research, Bremen, Germany
| | - Karin Wolf-Ostermann
- University of Bremen, High-Profile Area of Health Sciences, Bremen, Germany.,University of Bremen, Institute for Public Health and Nursing Research, Bremen, Germany
| | - Heinz Rothgang
- University of Bremen, SOCIUM Research Center on Inequality and Social Policy, Bremen, Germany.,University of Bremen, High-Profile Area of Health Sciences, Bremen, Germany
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Stockwell-Smith G, Adeleye A, Chaboyer W, Cooke M, Phelan M, Todd JA, Grealish L. Interventions to prevent in-hospital falls in older people with cognitive impairment for further research: A mixed studies review. J Clin Nurs 2020; 29:3445-3460. [PMID: 32578913 DOI: 10.1111/jocn.15383] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2019] [Revised: 05/13/2020] [Accepted: 05/17/2020] [Indexed: 11/28/2022]
Abstract
BACKGROUND While advances in falls prevention in the adult population have occurred, the care requirements for older patients with cognitive impairment at risk of falling are less established. OBJECTIVES To identify interventions to prevent in-hospital falls in older patients with cognitive impairment for further research and describe the strategies used to implement those interventions. DESIGN A seven-stage mixed studies review was used. METHODS Seven electronic databases were searched. The SPIDER framework guided the review question and selection of search terms. The Mixed Methods Assessment Tool was used to appraise the quality of research studies, and the Quality Improvement Minimum Quality Data Set was used to appraise the quality of quality improvement projects. A convergent qualitative synthesis was used to analyse the extracted data. The adapted PRISMA guideline informed the procedures. RESULTS Ten projects (five quality improvements and five researches) were included. Five themes emerged from the synthesis: engaging with families in falls prevention, assessing falls risk to identify interventions, extending nursing observation through technology, conducting a medication review and initiating nonpharmacological delirium prevention interventions. Implementation was not well described and commonly focused on capital investment to initiate a falls prevention programme and education to introduce staff to the new techniques for practice. CONCLUSIONS Emerging research and quality improvement studies demonstrate that effective falls prevention with this vulnerable population is possible but requires further investigation before widespread practice recommendations can be made. Further research and quality improvement in this area should consider adoption of an implementation framework to address sustainability. RELEVANCE TO CLINICAL PRACTICE Reducing falls in older people with cognitive impairment requires nurses to work more closely with pharmacists, occupational therapists and social workers to develop strategies that work and are sustainable.
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Affiliation(s)
| | - Adeniyi Adeleye
- Central Queensland University-Mackay Campus, Mackay, QLD, Australia
| | - Wendy Chaboyer
- School of Nursing & Midwifery, Griffith University, Southport, QLD, Australia.,Healthcare Practice and Survivorship Program, Menzies Health Institute Queensland, Griffith University, Gold Coast, QLD, Australia
| | - Marie Cooke
- School of Nursing & Midwifery, Griffith University, Southport, QLD, Australia.,Healthcare Practice and Survivorship Program, Menzies Health Institute Queensland, Griffith University, Nathan, QLD, Australia
| | | | - Jo-Anne Todd
- School of Nursing & Midwifery, Griffith University, Southport, QLD, Australia
| | - Laurie Grealish
- School of Nursing & Midwifery, Griffith University, Southport, QLD, Australia.,Healthcare Practice and Survivorship Program, Menzies Health Institute Queensland, Griffith University, Gold Coast, QLD, Australia.,Gold Coast Health, Gold Coast, QLD, Australia
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Abstract
Falls in hospitalized patients are a pressing patient safety concern, but there is a limited body of evidence demonstrating the effectiveness of commonly used fall prevention interventions in hospitals. This article reviews common study designs and the evidence for various hospital fall prevention interventions. There is a need for more rigorous research on fall prevention in the hospital setting.
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Mileski M, Brooks M, Topinka JB, Hamilton G, Land C, Mitchell T, Mosley B, McClay R. Alarming and/or Alerting Device Effectiveness in Reducing Falls in Long-Term Care (LTC) Facilities? A Systematic Review. Healthcare (Basel) 2019; 7:healthcare7010051. [PMID: 30934633 PMCID: PMC6473316 DOI: 10.3390/healthcare7010051] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2019] [Revised: 03/17/2019] [Accepted: 03/21/2019] [Indexed: 11/18/2022] Open
Abstract
Perceptions against the use of alarming devices persist in long-term care environments as they are seen as annoying, costly, and a waste of time to the staff involved. Ascertaining whether these perceptions are true or false via the literature was a focus of this study. Proper information to educate staff and to work past these perceptions can be a positive effector for resident safety. Many facilitators for the use of alarming devices were found, as well as many barriers to their use as well. New technology is changing the perceptions regarding these types of devices as time passes. Education is a key component for staff, residents, and families. There are “traditional” issues with the use of alarms such as alarm fatigue by caregivers, high costs of implementation, and issues with proper implementation of alarms. Alarms are perceived as intrusive and the noise from them can be a potential cause of falls. However, alarming devices can be a key intervention in the safety of those residents who are prone to falls. This requires proper implementation and education for all parties involved, and proper oversight surrounding use of the devices.
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Affiliation(s)
- Michael Mileski
- School of Health Administration, Texas State University, San Marcos, TX 78666, USA.
| | - Matthew Brooks
- School of Health Administration, Texas State University, San Marcos, TX 78666, USA.
| | - Joseph Baar Topinka
- School of Health Administration, Texas State University, San Marcos, TX 78666, USA.
| | - Guy Hamilton
- School of Health Administration, Texas State University, San Marcos, TX 78666, USA.
| | - Cleatus Land
- School of Health Administration, Texas State University, San Marcos, TX 78666, USA.
| | - Traci Mitchell
- School of Health Administration, Texas State University, San Marcos, TX 78666, USA.
| | - Brandy Mosley
- School of Health Administration, Texas State University, San Marcos, TX 78666, USA.
| | - Rebecca McClay
- School of Science, Technology, Engineering, and Math American Public University System, Charles Town, WV 25414, USA.
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Grealish L, Chaboyer W, Darch J, Real B, Phelan M, Soltau D, Lunn M, Brandis S, Todd JA, Cooke M. Caring for the older person with cognitive impairment in hospital: Qualitative analysis of nursing personnel reflections on fall events. J Clin Nurs 2019; 28:1346-1353. [PMID: 30520196 DOI: 10.1111/jocn.14724] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2018] [Revised: 11/02/2018] [Accepted: 11/26/2018] [Indexed: 11/28/2022]
Abstract
AIMS AND OBJECTIVES To explore nurse and nursing assistant reflections on the care of older patients with cognitive impairment who have experienced a fall. BACKGROUND While there are evidence-based clinical guidelines for the prevention and management of falls and for the care of older people with cognitive impairment, the falls rates for older people with cognitive impairment are three times as high as those without. DESIGN Critical incident technique. METHODS Eleven registered and two enrolled nurses and four assistants in nursing working in one subacute and two acute wards within two hospitals of a tertiary level health service in south-east Queensland. Individual semistructured interviews focused on two past events when a patient with cognitive impairment had fallen in hospital: one when there was minimal harm and the second when there was significant harm. Thematic analysis was undertaken. The COREQ checklist was followed. RESULTS Three themes emerged from 23 reflective accounts of fall events: "direct observation is confounded by multiple observers" and "knowing the person has cognitive impairment is not enough," and "want to rely on the guideline but unsure how to enact it." While participants were aware of the falls prevention policy and techniques available to prevent falls, the implementation of these was challenging due to the complexity of care required by the older person with cognitive impairment. CONCLUSIONS Falls prevention for older people with cognitive impairment is complex and belies the simple application of policy. RELEVANCE TO CLINICAL PRACTICE To reduce falls, nurses can involve the family to support "knowing the patient" to enable prediction of impulsive actions; shift the focus of in-service from lectures to specific case presentations, with collaborative analysis on person-focused strategies to prevent falls in older people with cognitive impairment; and reconsider the sitter role from simple observer to assistant, focused on ambulation and supporting independence in activities of daily living.
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Affiliation(s)
- Laurie Grealish
- Menzies Health Institute Queensland, Griffith University, QLD, Australia.,Gold Coast Hospital and Health Service, QLD, Australia.,School of Nursing & Midwifery, Griffith University, QLD, Australia
| | - Wendy Chaboyer
- Menzies Health Institute Queensland, Griffith University, QLD, Australia.,Gold Coast Hospital and Health Service, QLD, Australia.,School of Nursing & Midwifery, Griffith University, QLD, Australia
| | - Jacob Darch
- Gold Coast Hospital and Health Service, QLD, Australia
| | - Belinda Real
- Gold Coast Hospital and Health Service, QLD, Australia
| | - Maggie Phelan
- Gold Coast Hospital and Health Service, QLD, Australia
| | - Dawn Soltau
- Gold Coast Hospital and Health Service, QLD, Australia
| | - Matthew Lunn
- Gold Coast Hospital and Health Service, QLD, Australia
| | | | - Jo-Anne Todd
- School of Nursing & Midwifery, Griffith University, QLD, Australia
| | - Marie Cooke
- Menzies Health Institute Queensland, Griffith University, QLD, Australia.,School of Nursing & Midwifery, Griffith University, QLD, Australia
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A battery-less and wireless wearable sensor system for identifying bed and chair exits in a pilot trial in hospitalized older people. PLoS One 2017; 12:e0185670. [PMID: 29016696 PMCID: PMC5633180 DOI: 10.1371/journal.pone.0185670] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2016] [Accepted: 09/18/2017] [Indexed: 11/24/2022] Open
Abstract
Falls in hospitals are common, therefore strategies to minimize the impact of these events in older patients and needs to be examined. In this pilot study, we investigate a movement monitoring sensor system for identifying bed and chair exits using a wireless wearable sensor worn by hospitalized older patients. We developed a movement monitoring sensor system that recognizes bed and chair exits. The system consists of a machine learning based activity classifier and a bed and chair exit recognition process based on an activity score function. Twenty-six patients, aged 71 to 93 years old, hospitalized in the Geriatric Evaluation and Management Unit participated in the supervised trials. They wore over their attire a battery-less, lightweight and wireless sensor and performed scripted activities such as getting off the bed and chair. We investigated the system performance in recognizing bed and chair exits in hospital rooms where RFID antennas and readers were in place. The system’s acceptability was measured using two surveys with 0–10 likert scales. The first survey measured the change in user perception of the system before and after a trial; the second survey, conducted only at the end of each trial, measured user acceptance of the system based on a multifactor sensor acceptance model. The performance of the system indicated an overall recall of 81.4%, precision of 66.8% and F-score of 72.4% for joint bed and chair exit recognition. Patients demonstrated improved perception of the system after use with overall score change from 7.8 to 9.0 and high acceptance of the system with score ≥ 6.7 for all acceptance factors. The present pilot study suggests the use of wireless wearable sensors is feasible for detecting bed and chair exits in a hospital environment.
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Recognizing Bedside Events Using Thermal and Ultrasonic Readings. SENSORS 2017; 17:s17061342. [PMID: 28598394 PMCID: PMC5492489 DOI: 10.3390/s17061342] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/27/2017] [Revised: 05/24/2017] [Accepted: 06/06/2017] [Indexed: 11/23/2022]
Abstract
Falls in homes of the elderly, in residential care facilities and in hospitals commonly occur in close proximity to the bed. Most approaches for recognizing falls use cameras, which challenge privacy, or sensor devices attached to the bed or the body to recognize bedside events and bedside falls. We use data collected from a ceiling mounted 80 × 60 thermal array combined with an ultrasonic sensor device. This approach makes it possible to monitor activity while preserving privacy in a non-intrusive manner. We evaluate three different approaches towards recognizing location and posture of an individual. Bedside events are recognized using a 10-second floating image rule/filter-based approach, recognizing bedside falls with 98.62% accuracy. Bed-entry and exit events are recognized with 98.66% and 96.73% accuracy, respectively.
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Barker AL, Morello RT, Ayton DR, Hill KD, Brand CA, Livingston PM, Botti M. Acceptability of the 6-PACK falls prevention program: A pre-implementation study in hospitals participating in a cluster randomized controlled trial. PLoS One 2017; 12:e0172005. [PMID: 28199376 PMCID: PMC5310900 DOI: 10.1371/journal.pone.0172005] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2016] [Accepted: 01/30/2017] [Indexed: 11/25/2022] Open
Abstract
There is limited evidence to support the effectiveness of falls prevention interventions in the acute hospital setting. The 6-PACK falls prevention program includes a fall-risk tool; ‘falls alert’ signs; supervision of patients in the bathroom; ensuring patients’ walking aids are within reach; toileting regimes; low-low beds; and bed/chair alarms. This study explored the acceptability of the 6-PACK program from the perspective of nurses and senior staff prior to its implementation in a randomised controlled trial. A mixed-methods approach was applied involving 24 acute wards from six Australian hospitals. Participants were nurses working on participating wards and senior hospital staff including: Nurse Unit Managers; senior physicians; Directors of Nursing; and senior personnel involved in quality and safety or falls prevention. Information on program acceptability (suitability, practicality and benefits) was obtained by surveys, focus groups and interviews. Survey data were analysed descriptively, and focus group and interview data thematically. The survey response rate was 60%. Twelve focus groups (n = 96 nurses) and 24 interviews with senior staff were conducted. Falls were identified as a priority patient safety issue and nurses as key players in falls prevention. The 6-PACK program was perceived to offer practical benefits compared to current practice. Nurses agreed fall-risk tools, low-low beds and alert signs were useful for preventing falls (>70%). Views were mixed regarding positioning patients’ walking aid within reach. Practical issues raised included access to equipment; and risk of staff injury with low-low bed use. Bathroom supervision was seen to be beneficial, however not always practical. Views on the program appropriateness and benefits were consistent across nurses and senior staff. Staff perceived the 6-PACK program as suitable, practical and beneficial, and were open to adopting the program. Some practical concerns were raised highlighting issues to be addressed by the implementation plan.
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Affiliation(s)
- Anna L. Barker
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
- * E-mail:
| | - Renata T. Morello
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Darshini R. Ayton
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Keith D. Hill
- School of Physiotherapy and Exercise Science, Curtin University, Bentley, Western Australia, Australia
| | - Caroline A. Brand
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Patricia M. Livingston
- Epworth/Deakin Centre for Clinical Nursing Research, Deakin University, Richmond, Victoria, Australia
| | - Mari Botti
- School of Nursing and Midwifery, Deakin University, Burwood, Victoria, Australia
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Effectiveness of a Batteryless and Wireless Wearable Sensor System for Identifying Bed and Chair Exits in Healthy Older People. SENSORS 2016; 16:s16040546. [PMID: 27092506 PMCID: PMC4851060 DOI: 10.3390/s16040546] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/09/2015] [Revised: 03/17/2016] [Accepted: 04/06/2016] [Indexed: 01/06/2023]
Abstract
Aging populations are increasing worldwide and strategies to minimize the impact of falls on older people need to be examined. Falls in hospitals are common and current hospital technological implementations use localized sensors on beds and chairs to alert caregivers of unsupervised patient ambulations; however, such systems have high false alarm rates. We investigate the recognition of bed and chair exits in real-time using a wireless wearable sensor worn by healthy older volunteers. Fourteen healthy older participants joined in supervised trials. They wore a batteryless, lightweight and wireless sensor over their attire and performed a set of broadly scripted activities. We developed a movement monitoring approach for the recognition of bed and chair exits based on a machine learning activity predictor. We investigated the effectiveness of our approach in generating bed and chair exit alerts in two possible clinical deployments (Room 1 and Room 2). The system obtained recall results above 93% (Room 2) and 94% (Room 1) for bed and chair exits, respectively. Precision was >78% and 67%, respectively, while F-score was >84% and 77% for bed and chair exits, respectively. This system has potential for real-time monitoring but further research in the final target population of older people is necessary.
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