Using Patient Wearable Devices To Prevent
Hospital Acquired Pressure Injuries
Preventing pressure injuries in hospitalized patients has been performed the same way for 150 years - Nurses routinely re-positioning patients every two hours. Though it makes theoretical sense to regularly re-position patients, few empirical studies have been able to demonstrate a benefit. This can be attributed to the difficulties in measuring nursing practice.
In 2014 Leaf Healthcare was a new medical-device company that developed a wearable patient monitoring system that quantified the nursing practices related to preventive patient turning. The 'Leaf' device had a built in Gyrometer that when attached to a patient, tracked the patients position and communicated to the nurse an estimated time-to-next to patient turn.
The system had been trialed at local hospitals and shown to improve nurse’s adherence to patient turning procedures. At Stanford Health Care we were curious whether using the device to create ‘optimal’ patient turning conditions would led to a reduction in the development of hospital acquired pressure injuries.
To achieve this, we partnered with Leaf Healthcare to conduct a large-scale randomized control trial in two intensive care units at Stanford. A wireless network was established in over 50 patient beds. A HL7 feed was used to correctly locate patients and a wearable patient device was applied to all new admissions. Nearly 1500 patients were allocated to an intervention group (receiving data feedback) and a control group (no data feedback).
For the first time we were able to quantify patient turning practices. We found that the Leaf device had a protective effect, reducing the incidence of hospital-acquired pressure injuries. We were able to describe typical turning practices and was surprised to identify latent biases in preventive care measures. Based on this study, Stanford Health Care has since incorporated the Leaf sensor into clinical practice.
The study was acknowledged by the National Pressure Ulcer Advisory Panel in 2018, and in 2019 Leaf Healthcare was acquired by Smith & Nephew.
Role: Principal Investigator/sponsor
Team: Nic Berte, Manisha Desai, Andre Valdez, Barbara Mayer (Stanford); Barrett Larson, Mike Phulic (Leaf Healthcare).
Publications.
1. Pickham, D., Ballew, B., Ebong, K., Shinn, J., Lough, M., & Mayer, B. (2016). Open Label Randomized Control Trial Evaluating Optimal Patient Turning Procedures for Reducing Hospital Acquired Pressure Ulcers: Study Protocol for the LS-HAPU Study. Trials. 17(1): 190.
2. Pickham, D., Berte, N., Pihulic, M., Valdez, A., Mayer, B., & Desai, M. (2017). Effect of a Wearable Patient Sensor on Care Delivery for Preventing Pressure Injuries in Acutely Ill Adults: A Randomized Clinical Trial (LS-HAPI Study). International Journal of Nursing Studies. 80: 12-19.
3. Pickham, D., Pihulic, M., Betsy, B., Valdez, A., Mayer, B., Duhon, P., & Larson, B. (2018). Observation Study Using Wearable Patient Sensors to Assess Pressure Injury Prevention Practices in Intensive Care Units. Wounds – A Compendium of Clinical Research and Practice. 30(8): 229-234.
