Fall-Prevention

Fall-Safe – Hip Fracture and Fall Prevention

This Fall-Safe pad was allied to a double-sided adhesive film that attaches it gently, but firmly, to the hip so that the pad can be worn 24/7 – for the first time – in bed, bath, and shower, as with a wound dressing. This product is currently being implemented widely by the Dept. of Veterans Affairs in the USA, the largest such organization in the world, with c. 500 hospitals. That solves the hip fracture problem ( @ £60 per wearer), but does not address the central problem of falls prevention.

34% of A & E admissions are due to falls by the elderly, and 25% of those occupy long-term hospital beds, according to Imperial College Health Partners in 2017. Almost 90,000 people in the UK suffer a hip fracture from a fall each year, and c. 30% of those die within a year. The situation is bad, despite such nostrums as “multifactorial interventions” (proven ineffective by the 6-PACK trial in Australia), and it is getting worse as the population ages.

HIP started in 2010 from the premise that it must be possible to prevent all hip fractures if a sufficiently effective and at the same time comfortable hip protector pad was applied to the problem, and the patient. That view has proved to be correct, using modern impact-absorbing materials incorporating a dilatant that hardens the slim (13mm) pad instantly on impact to absorb and diffuse the force by 70%, resulting in 0% hip fractures when the pads are being worn.

A recent trial in Canada examined the effect of hip protectors for reducing the risk of hip fracture and included over 1,000 older adults from 14 nursing homes followed over a 1-year period. They experienced more than 3,500 falls (some fell multiple times). Even though the hip protectors used were only worn about 60% of the time, they reduced the number of broken hips by 64%.

At the same time, data on each fall is sent to a cloud database, including such characteristics as the time, ID #, direction of fall, and force of the fall. This data will be augmented by manually input information on the faller and the relevant room environment so that it can be collated with all other recorded falls and analyzed to identify predictors of falls, which should enable action to be taken locally to prevent similar incidents in future.

HIP has produced this system in its entirety and intends to install it shortly in care homes in the UK. It is unique, and patented in the UK, USA, and Europe. The cost for a large 60-bed care home, with typically 10% regular fallers, would be < £2,500. In any one-year period there would, on average, be one hip fracture there, costing the NHS c. £30,000 to repair, and for subsequent rehabilitation.

There are also significantly higher care costs than those prior to the accident, associated with the return of a resident after a hip fracture operation.

There have been a number of attempts to detect falls – the precursor to doing something about preventing them – using pendants swinging around the neck, and electronic wristwatch-type devices waving about on the wrist. As could have been predicted, the ratio of false positive alarms to actual falls has been more than sufficient to render such devices ineffective, indeed dangerous, since a false sense of safety results.

Other fall detection devices in belts, for example, have proven impractical – and dangerous as well for other reasons. HIP have embedded a fall detection sensor in our Fall-Safe pads, see above, which detects all falls since the hip is the most stable part of the body, since any sudden downward movement is bound to be a fall, so the algorithm used has proved to be infallible.

This sensor transmits an alarm message to a control box, located centrally in a hospital or care home, and wirelessly linked to up to 10 such sensors, to enable help to be summoned locally, or automatically from the emergency services, as appropriate. It is appropriate for use in hospitals, care homes, etc.

In 2023 HIP secured an award of £50,000 from Innovate UK to complete the design and production of the falls database so that the entire chain is now complete from a fall event being registered, through to that fall data being inserted into the falls database. It is ready for implementation in care homes.