CHAMGAP
APPROVEDReviewed and approved by the Chamgap Editorial Team (2026-08-05). The draft was written by AI, the existence of all 2 cited sources was verified at the original page, and the verdict passed blind grading and adversarial audit. Methodology v0.6.
Verdict No. 2310 · Search date 2026-08-05 · Methodology v0.6

Bed-exit alarms,
does it really help with Reduced inpatient falls and injurious falls?

30-Second Summary
D
Evidence Grade D · 28 · Safety caution
Greatly increasing bed-exit alarm use did not reduce hospital falls, but important benefit was not excluded
False alerts, alarm fatigue, and sleep disruption can occur, and reliance on alarms may delay direct observation or environmental prevention. Alarms should not be used as physical restraints.
What the
research shows
The grade is D. In a cluster-randomized trial of 16 nursing units and 27,672 patients, alarm use was about 36-fold higher but remained only 64.41 versus 1.79 alarm-days per 1,000 patient-days. There were 315 falls over 59,011 patient-days in intervention units and 408 over 83,604 patient-days in control units; the adjusted rate ratio was 1.09 (95% CI 0.85 to 1.53). The Sahota team's 1,839-person trial was also null, but neither trial excluded clinically important benefit, giving D with 28 points.
What the
ads claim
The result cannot be presented as the effect of an alarm sound alone. The trial tested a bundle of training and technical support that expanded alarm use, and that full bundle did not reduce falls.
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Useful facts when choosing a product

  • The Shorr study was a cluster-randomized trial of 16 units and 27,672 patients.
  • Alarm use was 64.41 versus 1.79 alarm-days per 1,000 patient-days.
  • The Sahota trial individually randomized 1,839 patients to a pressure-sensor alarm or no sensor.
Gap Measurement · Verdict 2310 · D 28
What advertising claims
What independent, higher-quality research supports
△ GAP
01

What the research actually shows

The Shorr trial paired units by baseline fall rate, randomized 16 units, and used a negative-binomial model accounting for unit clustering and baseline falls. The intervention was a bundle to increase use of existing bed and chair pressure alarms: nurse education, use training, and technical support. Control units retained access to alarms but did not receive systematic promotion, training, or technical support. Blinding patients and frontline staff was infeasible, while outcome adjudicators were masked. Falls nevertheless depended on staff reporting, leaving an avoidable possibility that unit assignment influenced ascertainment.

02

Why this is classified as D (28)

Separate publicly funded large trials repeatedly failed to show fewer falls, but their intervals did not exclude clinically important benefit, giving D with 28 points.

Counterpoint. Failure to reduce a hospital-wide fall rate does not prove that alarms have no operational use for any selected patient. Supporting observation or notification is a different question from preventing falls across a hospital population.

Rejudgment record. Cross-check applied — Cluster adjustment, delivered alarm use, absolute falls and injurious falls, and an independent repeat trial were checked separately

Scoring profile behind this grade
EndpointHHard endpoint - actual events such as death
ReplicationRXRepeatedly refuted in the same indication
IndependenceI2Decisive evidence is publicly or non-profit funded
Effect sizeE0Null
PrecisionC0The confidence interval leaves room for benefit

The scoring table and the verdict agree (D).

Sub-claim grades by effect

This ingredient is marketed for several effects. A single overall grade blends strong and weak claims together, so each effect is graded separately here. The overall grade reflects the strongest disconfirming or core claim.

Effect (sub-claim)GradeBasis
Reduced all inpatient fallsDTwo separate large randomized trials were null, but clinically important benefit was not excluded.
Reduced injurious fallsDThe Shorr trial found 77 of 315 versus 111 of 408, with an imprecise adjusted estimate.

Cross-check — Codex and Claude

This verdict was drafted by Codex through literature review and source-existence checks, cross-checked through blind grading and adversarial audit, and settled by reapplying the methodology boundary rules. Cases with split grades were resolved through rejudgment.
03

Evidence Table

StudyDesignSampleFundingEndpointResultWeight
Study 1Cluster-randomized trial across 16 nursing units142,615Public funding from the US National Institute on AgingHospital fall rate and injurious falls315 falls over 59,011 patient-days versus 408 over 83,604; adjusted RR 1.09 (0.85 to 1.53). Injurious falls 77 of 315 versus 111 of 408; adjusted RR 1.42 (0.77 to 3.34)Decisive cluster trial
Study 2Individually randomized pressure-sensor trial921Public funding from the UK National Institute for Health ResearchFalls per 1,000 bed-days and injurious falls85 falls at 8.71 versus 83 at 9.84 per 1,000 bed-days, adjusted IRR 0.90 (0.66 to 1.22); minor injury 24 versus 16, major injury or fracture 2 versus 3Independent repeat null trial
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Receipt — 2 References

All 2 cited sources were verified for existence at the original page (as of 2026-08-05).

Shorr RI, Chandler AM, Mion LC, et al. Effects of an intervention to increase bed alarm use to prevent falls in hospitalized patients: a cluster randomized trial. Ann Intern Med. 2012;157(10):692-699. PMID: 23165660. DOI: 10.7326/0003-4819-157-10-201211200-00005.
checked
Sahota O, Drummond A, Kendrick D, et al. REFINE (REducing Falls in In-patieNt Elderly) using bed and bedside chair pressure sensors linked to radio-pagers in acute hospital care: a randomised controlled trial. Age Ageing. 2014;43(2):247-253. PMID: 24222660. DOI: 10.1093/ageing/aft155.
checked
Draft and rewrite: Codex (AI) · Verification: Codex blind grading and adversarial audit · Final adjudication: Claude
Reviewed and approved: Chamgap Editorial Team · Approval date: 2026-08-05 · Corrections: none

Cite this verdict

Bed-exit alarms x hospital falls Evidence Grade D card
[Chamgap] Bed-exit alarms x hospital falls — Evidence Grade D·28. 2 cited sources checked. Source: https://chamgap.com/en/verdicts/joint-bone/bed-exit-alarms-hospital-falls/ · CC BY 4.0

CC BY 4.0 — free to use with attribution; do not distort grades, numbers, or verdict meaning.

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