By Amy Hester

The healthcare sector is rapidly adopting advanced technologies to improve patient safety and healthcare quality. A notable initiative led by the Food and Drug Administration’s (FDA) device center aims to stimulate innovation in at-home medical devices.

With an investment of $1.2 million, the center is developing a Virtual Reality (VR) hub designed to provide resources for developers, policymakers and healthcare providers. The goal is to enhance patient safety solutions through evidence-based insights into at-home medical technologies. This initiative intends to address healthcare disparities by empowering stakeholders to understand and improve in-home healthcare solutions.

Tech-enabled strategies for enhanced patient safety at home
Integrating advanced technologies into Hospital at Home (HaH) settings is crucial for minimizing the risks of falls and pressure injuries, particularly in elderly populations. Leveraging tech-enabled solutions offers the opportunity to significantly improve patient safety and healthcare outcomes while providing care within patients' homes. The adoption of precision nursing, validated assessments and digital health monitoring systems enhances patient care in these home settings.

Falls pose a significant health risk, especially for individuals aged 65 and older. Each year, over a quarter of this population experiences a fall, doubling their likelihood of another fall in the future. Less than half of these incidents are reported to healthcare providers, leaving many potential safety concerns unaddressed.

The aftermath leads to millions of emergency department visits annually, causing severe injuries like hip fractures and traumatic brain injuries (TBIs). In 2015, medical expenses associated with falls surpassed $50 billion, creating a considerable burden on the healthcare system.

Multiple factors contribute to the risk of falling, such as weakened muscles, medication side effects, vision impairment and unsafe living environments. Addressing these factors requires a comprehensive strategy that emphasizes advanced patient safety solutions within the HaH setting.

This includes implementing nursing fall risk assessments and developing comprehensive nursing care plans for fall prevention. These steps are essential to improving patient safety and reducing healthcare costs while enhancing healthcare quality.

Advanced fall prevention technologies for hospital at home care
Advanced, tech-enabled solutions bring innovative methods to reduce fall risks in the Hospital at Home (HaH) setting:

• Smart sensors and wearable devices: These devices actively track patient movements, identifying irregular patterns and notifying healthcare professionals in real-time. By providing evidence-based data, healthcare providers can respond swiftly and proactively intervene, significantly reducing the chances of future falls. These devices can include wearable sensors that detect changes in gait or balance and send alerts to caregivers or healthcare professionals, enabling prompt action.
• Virtual reality and simulation training: The FDA's VR hub empowers healthcare professionals through immersive, realistic fall-prevention training, equipping practitioners with the skills and knowledge to apply best practices in fall prevention effectively. Through virtual reality training modules, healthcare workers can practice identifying fall risks in a controlled environment before implementing these skills in real-world settings, making it a valuable tool for nursing solutions.
• Automated lighting and environmental control: Automated lighting systems adapt to ambient conditions, mitigating potential fall risks at home, especially at night, by adjusting illumination and removing trip hazards. These systems can detect motion, adjusting lighting to help patients safely navigate their homes and avoid obstacles that could lead to falls.
• Digital health monitoring systems: These systems provide continuous health monitoring, issuing automatic alerts for any changes in a patient’s condition that might increase the likelihood of falls, such as fluctuating blood pressure or irregular blood sugar levels. By continuously monitoring health metrics, these systems allow for timely interventions to prevent falls, especially in patients with chronic conditions that affect balance or stability.

Tech-driven strategies to prevent pressure injuries at home
Pressure injuries, also known as bed sores, also present a significant challenge in HaH and acute care settings. These injuries can lead to complications such as infections and prolonged hospital stays. Effectively preventing these injuries requires a multidisciplinary approach, with strategies tailored to each patient's needs and comprehensive geriatric safety protocols.

Advanced technology offers innovative solutions to revolutionize the prevention of pressure injuries:

• Skin care protocols and monitoring: Digital platforms enforce rigorous skin care protocols, tracking adherence to specialized routines. Automated reminders facilitate the regular use of cleansers and moisturizers to help maintain skin integrity and prevent pressure injuries. This allows caregivers to closely monitor patients’ skin health and adjust care protocols as needed.
• AI-based nutritional support: AI-driven analysis assesses patients' nutritional status, detecting malnutrition early and allowing registered dietitians to design customized nutrition plans. Proper nutrition is critical to maintaining healthy skin and preventing pressure injuries and AI analysis helps ensure patients receive personalized care.
• Smart positioning and support surfaces: Intelligent tools dynamically adjust patient positioning according to specific needs, helping prevent pressure injuries by reducing strain and ensuring optimal patient positioning. These tools can adjust pressure distribution across support surfaces, reducing the likelihood of developing pressure injuries.

The role of leadership in implementing tech solutions for safety
Strong leadership in healthcare organizations is crucial for adopting advanced solutions, whether in the acute care environment or HaH settings. By implementing detailed nursing protocols that emphasize high reliability, leaders can ensure healthcare staff are adequately trained to use these technologies.

Continuous evaluation of patient outcomes and adherence to established procedures are vital for improving healthcare quality and maintaining the effectiveness of patient safety initiatives. Leaders should emphasize ongoing training, performance reviews and the adaptation of protocols to integrate the latest technology for fall and pressure injury prevention.

Embracing tech-enabled tools in the Hospital at Home (HaH) setting is essential to reducing the risks of falls and pressure injuries. The FDA’s initiative highlights the need for innovative healthcare safety solutions that tackle these challenges in in-home care environments.

By integrating intelligent sensors, wearable devices, virtual reality training and digital health monitoring systems, HaH can offer comprehensive, high-quality care that elevates patient safety and outcomes.

About the author: Dr. Amy Hester, PhD, RN, BC, FAAN, is the chairwoman and CEO of HD Nursing. Amy has 25 years of nursing experience including over a decade of med/surge and neuro nursing followed by unit management and hospital administration. In 2015, she earned a Doctor of Philosophy in Nursing Science and has since published and spoken extensively on the subject of falls and injury prediction and prevention. She retired from UAMS in 2018 after 26 years of service to dedicate her time fully to HD Nursing. She is adjunct faculty at UAMS College of Nursing. As an entrepreneur, she mentors others to help them with their own endeavors. Amy also serves as the Chair of the HD Nursing Board of Directors.